Reports from University of Pittsburgh Add New Data to Findings in Internal Medicine (Association Between Provider-sponsored Health Plan Ownership and Health Insurance Marketplace Plan Quality): Health and Medicine – Internal Medicine

2022 MAR 22 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Data detailed on Health and Medicine - Internal Medicine have been presented. According to news reporting originating in Pittsburgh, Pennsylvania, by NewsRx journalists, research stated, “Over 15.3 million Americans relied on the individual health insurance market for health coverage in 2021. Yet, little is known about the relationships between the organizational characteristics of individual market health insurers and quality of coverage, particularly with respect to clinical outcomes.”

The news reporters obtained a quote from the research from the University of Pittsburgh, “To examine variation in marketplace insurers’ quality performance and investigate how performance varies by insurer organizational characteristics. Retrospective cohort study. Participants 381 insurer products, representing 184 unique insurers in 50 states in 2019 and 2020. Marketplace plan clinical quality measures reported in the 2019-2020 CMS Plan Quality Rating System dataset and insurer-product organizational attributes identified from several data sources, including non-profit ownership, Blue Cross Blue Shield Association membership, Medicaid focus and whether or not the insurer product is vertically integrated with a provider organization. Among the 381 insurer products in this study, 35% are part of a provider-sponsored health plan (PSHP) and 70% of these entities received four stars or above for overall quality performance. Overall, PSHPs exhibited higher quality than non-PSHPs for both clinical quality management (0.36 increased on a 5-point scale; 95% CI = 0.11 to 0.62; P = 0.005) and enrollee experience (0.27; 95% CI = 0.03 to 0.50; P = 0.03) summary indicators. Medicaid focused insurers were associated with lower performance on enrollee experience, plan administration, and various outcomes related to clinical quality.”

According to the news reporters, the research concluded: “Provider-sponsored health plans in the health insurance marketplaces are associated with higher-quality care, as measured by CMS clinical quality measures.”

This research has been peer-reviewed.

For more information on this research see: Association Between Provider-sponsored Health Plan Ownership and Health Insurance Marketplace Plan Quality. Journal of General Internal Medicine, 2022. Journal of General Internal Medicine can be contacted at: Springer, One New York Plaza, Suite 4600, New York, Ny, United States. (Wiley-Blackwell - http://www.wiley.com/; Journal of General Internal Medicine - http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1525-1497)

Our news correspondents report that additional information may be obtained by contacting Sih-Ting Cai, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA 15260, United States. Additional authors for this research include Coleman Drake, David Anderson and Jean M. Abraham.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1007/s11606-022-07407-6. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

(Our reports deliver fact-based news of research and discoveries from around the world.)