Variation in tiered network health plan penetration and local provider market characteristics
Objective To understand variation in enrollment in tiered network health plans (TNPs) and the local provider market characteristics associated with TNP penetration. Data Sources and Study Setting We used 2013–2017 Massachusetts three‐digit ZIP code level employer‐sponsored health insurance enrollmen...
Uloženo v:
| Vydáno v: | Health services research Ročník 59; číslo 4; s. e14223 - n/a |
|---|---|
| Hlavní autoři: | , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
Oxford, UK
Blackwell Publishing Ltd
01.08.2024
|
| Témata: | |
| ISSN: | 0017-9124, 1475-6773, 1475-6773 |
| On-line přístup: | Získat plný text |
| Tagy: |
Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
|
| Abstract | Objective
To understand variation in enrollment in tiered network health plans (TNPs) and the local provider market characteristics associated with TNP penetration.
Data Sources and Study Setting
We used 2013–2017 Massachusetts three‐digit ZIP code level employer‐sponsored health insurance enrollment data, data on physician horizontal and vertical affiliations from the Massachusetts Provider Database, state hospital reports in 2013, 2015, and 2017, and the 2013–2017 Massachusetts All‐Payer Claims database.
Study Design
Linear regressions were used to estimate associations between TNP and local provider market characteristics.
Data Extraction
We constructed measures of TNP penetration and local provider market characteristics and linked these data using three‐digit ZIP code.
Principal Findings
TNP penetration was at least 10% in all employer market sectors and highest among jumbo sized employers. All state employee health plan enrollees were in a tiered network health plan. Among enrollees not in the state employee health plan, TNP penetration varied from 6.0% to 19.6% across three‐digit ZIP codes in Massachusetts. TNP penetration was higher in areas with less horizontal and vertical physician market concentration.
Conclusions
Market competition, rather than the absolute quantity of physicians in an area, is associated with TNP penetration. |
|---|---|
| AbstractList | Objective
To understand variation in enrollment in tiered network health plans (TNPs) and the local provider market characteristics associated with TNP penetration.
Data Sources and Study Setting
We used 2013–2017 Massachusetts three‐digit ZIP code level employer‐sponsored health insurance enrollment data, data on physician horizontal and vertical affiliations from the Massachusetts Provider Database, state hospital reports in 2013, 2015, and 2017, and the 2013–2017 Massachusetts All‐Payer Claims database.
Study Design
Linear regressions were used to estimate associations between TNP and local provider market characteristics.
Data Extraction
We constructed measures of TNP penetration and local provider market characteristics and linked these data using three‐digit ZIP code.
Principal Findings
TNP penetration was at least 10% in all employer market sectors and highest among jumbo sized employers. All state employee health plan enrollees were in a tiered network health plan. Among enrollees not in the state employee health plan, TNP penetration varied from 6.0% to 19.6% across three‐digit ZIP codes in Massachusetts. TNP penetration was higher in areas with less horizontal and vertical physician market concentration.
Conclusions
Market competition, rather than the absolute quantity of physicians in an area, is associated with TNP penetration. To understand variation in enrollment in tiered network health plans (TNPs) and the local provider market characteristics associated with TNP penetration.OBJECTIVETo understand variation in enrollment in tiered network health plans (TNPs) and the local provider market characteristics associated with TNP penetration.We used 2013-2017 Massachusetts three-digit ZIP code level employer-sponsored health insurance enrollment data, data on physician horizontal and vertical affiliations from the Massachusetts Provider Database, state hospital reports in 2013, 2015, and 2017, and the 2013-2017 Massachusetts All-Payer Claims database.DATA SOURCES AND STUDY SETTINGWe used 2013-2017 Massachusetts three-digit ZIP code level employer-sponsored health insurance enrollment data, data on physician horizontal and vertical affiliations from the Massachusetts Provider Database, state hospital reports in 2013, 2015, and 2017, and the 2013-2017 Massachusetts All-Payer Claims database.Linear regressions were used to estimate associations between TNP and local provider market characteristics.STUDY DESIGNLinear regressions were used to estimate associations between TNP and local provider market characteristics.We constructed measures of TNP penetration and local provider market characteristics and linked these data using three-digit ZIP code.DATA EXTRACTIONWe constructed measures of TNP penetration and local provider market characteristics and linked these data using three-digit ZIP code.TNP penetration was at least 10% in all employer market sectors and highest among jumbo sized employers. All state employee health plan enrollees were in a tiered network health plan. Among enrollees not in the state employee health plan, TNP penetration varied from 6.0% to 19.6% across three-digit ZIP codes in Massachusetts. TNP penetration was higher in areas with less horizontal and vertical physician market concentration.PRINCIPAL FINDINGSTNP penetration was at least 10% in all employer market sectors and highest among jumbo sized employers. All state employee health plan enrollees were in a tiered network health plan. Among enrollees not in the state employee health plan, TNP penetration varied from 6.0% to 19.6% across three-digit ZIP codes in Massachusetts. TNP penetration was higher in areas with less horizontal and vertical physician market concentration.Market competition, rather than the absolute quantity of physicians in an area, is associated with TNP penetration.CONCLUSIONSMarket competition, rather than the absolute quantity of physicians in an area, is associated with TNP penetration. To understand variation in enrollment in tiered network health plans (TNPs) and the local provider market characteristics associated with TNP penetration. We used 2013-2017 Massachusetts three-digit ZIP code level employer-sponsored health insurance enrollment data, data on physician horizontal and vertical affiliations from the Massachusetts Provider Database, state hospital reports in 2013, 2015, and 2017, and the 2013-2017 Massachusetts All-Payer Claims database. Linear regressions were used to estimate associations between TNP and local provider market characteristics. We constructed measures of TNP penetration and local provider market characteristics and linked these data using three-digit ZIP code. TNP penetration was at least 10% in all employer market sectors and highest among jumbo sized employers. All state employee health plan enrollees were in a tiered network health plan. Among enrollees not in the state employee health plan, TNP penetration varied from 6.0% to 19.6% across three-digit ZIP codes in Massachusetts. TNP penetration was higher in areas with less horizontal and vertical physician market concentration. Market competition, rather than the absolute quantity of physicians in an area, is associated with TNP penetration. ObjectiveTo understand variation in enrollment in tiered network health plans (TNPs) and the local provider market characteristics associated with TNP penetration.Data Sources and Study SettingWe used 2013–2017 Massachusetts three‐digit ZIP code level employer‐sponsored health insurance enrollment data, data on physician horizontal and vertical affiliations from the Massachusetts Provider Database, state hospital reports in 2013, 2015, and 2017, and the 2013–2017 Massachusetts All‐Payer Claims database.Study DesignLinear regressions were used to estimate associations between TNP and local provider market characteristics.Data ExtractionWe constructed measures of TNP penetration and local provider market characteristics and linked these data using three‐digit ZIP code.Principal FindingsTNP penetration was at least 10% in all employer market sectors and highest among jumbo sized employers. All state employee health plan enrollees were in a tiered network health plan. Among enrollees not in the state employee health plan, TNP penetration varied from 6.0% to 19.6% across three‐digit ZIP codes in Massachusetts. TNP penetration was higher in areas with less horizontal and vertical physician market concentration.ConclusionsMarket competition, rather than the absolute quantity of physicians in an area, is associated with TNP penetration. |
| Author | Rosenthal, Meredith B. Curto, Vilsa E. Bambury, Elizabeth Soto, Mark J. Sinaiko, Anna D. |
| AuthorAffiliation | 1 Department of Health Policy & Management Harvard T.H. Chan School of Public Health Boston Massachusetts USA |
| AuthorAffiliation_xml | – name: 1 Department of Health Policy & Management Harvard T.H. Chan School of Public Health Boston Massachusetts USA |
| Author_xml | – sequence: 1 givenname: Anna D. orcidid: 0000-0003-4230-1947 surname: Sinaiko fullname: Sinaiko, Anna D. email: asinaiko@hsph.harvard.edu organization: Harvard T.H. Chan School of Public Health – sequence: 2 givenname: Vilsa E. orcidid: 0000-0001-9947-4094 surname: Curto fullname: Curto, Vilsa E. organization: Harvard T.H. Chan School of Public Health – sequence: 3 givenname: Elizabeth surname: Bambury fullname: Bambury, Elizabeth organization: Harvard T.H. Chan School of Public Health – sequence: 4 givenname: Mark J. surname: Soto fullname: Soto, Mark J. organization: Harvard T.H. Chan School of Public Health – sequence: 5 givenname: Meredith B. orcidid: 0000-0003-3410-0184 surname: Rosenthal fullname: Rosenthal, Meredith B. organization: Harvard T.H. Chan School of Public Health |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/37670453$$D View this record in MEDLINE/PubMed |
| BookMark | eNqFkc1rFTEUxYNU7Gt17U4CbtxMm487ycxKpFRbKAh-7STkJff50s5LxmReS_978zr1oW7MJnDzO5dzco7IQUwRCXnJ2Qmv55SDbhultTzhIIR8Qhb7yQFZMMZ103MBh-SolGvGWCc7eEYOpVaaQSsX5Ps3m4OdQoo0RDoFzOhpxOku5Ru6RjtMazoONtIR6zTPpI2eDsnZgY453QaPmW5svsGJurXN1k2YQ5mCK8_J05UdCr54vI_J1_fnX84umquPHy7P3l01DoSUDfRK2B4V832Lspe9FxphqXCJ6BA4alz1S913DlqtOu_Bc0CwWgJAz5k8Jm_nveN2uUHvMFargxlzqL7uTbLB_P0Sw9r8SLeGc9EyELpuePO4IaefWyyT2YTicKjRMW2LEZ3iChRjsqKv_0Gv0zbHms9I1rGu4zVBpV79aWnv5ffXV-B0BlxOpWRc7RHOzK5cs6vS7Ko0D-VWhZoVd2HA-__h5uL886dZ-AudAKbk |
| Cites_doi | 10.1016/j.jhealeco.2021.102569 10.1377/forefront.20220509.99893 10.37765/ajmc.2021.88744 10.1377/hlthaff.2021.00727 10.1377/hlthaff.2016.1087 10.1016/j.jhealeco.2016.08.006 10.1257/app.20180422 10.1086/714360 |
| ContentType | Journal Article |
| Copyright | 2023 Health Research and Educational Trust. 2024 Health Research and Educational Trust |
| Copyright_xml | – notice: 2023 Health Research and Educational Trust. – notice: 2024 Health Research and Educational Trust |
| DBID | AAYXX CITATION CGR CUY CVF ECM EIF NPM 7QJ K9. 7X8 5PM |
| DOI | 10.1111/1475-6773.14223 |
| DatabaseName | CrossRef Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed Applied Social Sciences Index & Abstracts (ASSIA) ProQuest Health & Medical Complete (Alumni) MEDLINE - Academic PubMed Central (Full Participant titles) |
| DatabaseTitle | CrossRef MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) ProQuest Health & Medical Complete (Alumni) Applied Social Sciences Index and Abstracts (ASSIA) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE - Academic MEDLINE ProQuest Health & Medical Complete (Alumni) |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine Public Health |
| DocumentTitleAlternate | Sinaiko et al |
| EISSN | 1475-6773 |
| EndPage | n/a |
| ExternalDocumentID | PMC11250427 37670453 10_1111_1475_6773_14223 HESR14223 |
| Genre | shortCommunication Research Support, Non-U.S. Gov't Journal Article |
| GeographicLocations | Massachusetts United States--US |
| GeographicLocations_xml | – name: Massachusetts – name: United States--US |
| GrantInformation_xml | – fundername: Arnold Ventures – fundername: NIA NIH HHS grantid: K01 AG073583 |
| GroupedDBID | --- --Z -~X ..I .3N .GA .GJ .Y3 05W 0R~ 10A 1CY 1OC 29I 2WC 31~ 33P 36B 4.4 44B 50Y 50Z 51W 51Y 52M 52O 52Q 52R 52S 52T 52U 52V 52W 53G 5GY 5HH 5LA 5VS 66C 702 7PT 8-0 8-1 8-3 8-4 8-5 8GL 8UM 930 A01 A04 AABNI AAESR AAFWJ AAHHS AAHQN AAIPD AAMNL AANHP AAONW AAOUF AARRQ AASGY AAWTL AAXRX AAYCA AAZKR ABCQN ABCUV ABDBF ABEML ABIVO ABJNI ABOCM ABPPZ ABPVW ABQWH ABSOO ABXGK ACAHQ ACBKW ACBWZ ACCFJ ACCZN ACGFO ACGFS ACGOF ACHQT ACMXC ACNCT ACPOU ACRPL ACSCC ACUHS ACXQS ACYXJ ADBBV ADBTR ADEMA ADEOM ADIZJ ADKYN ADMGS ADNMO ADXAS ADZMN ADZOD AEEZP AEGXH AEIGN AEIMD AENEX AEQDE AEUQT AEUYR AFBPY AFEBI AFFPM AFGKR AFKFF AFPWT AFRAH AFWVQ AFYRF AFZJQ AHBTC AHMBA AI. AIACR AIAGR AIFKG AIURR AIWBW AJBDE ALAGY ALMA_UNASSIGNED_HOLDINGS ALUQN ALVPJ AMBMR AMYDB AOIJS ASPBG ASTYK AVWKF AZBYB AZFZN AZVAB BAAKF BAFTC BAWUL BDRZF BFHJK BKOMP BMXJE BNVMJ BQESF BROTX BRXPI BY8 C1A C45 CAG COF CS3 D-6 D-7 D-C D-D DCZOG DIK DPXWK DR2 DRFUL DRMAN DRSSH DU5 E3Z EAD EAP EAS EBD EBS EJD EMB EMK EMOBN EOH ESX EX3 F00 F01 F5P FD6 FEDTE FUBAC G-S G.N G50 GICCO GODZA GX1 HGLYW HVGLF HYE HZI HZ~ IAO IBB IEA IGG IHE IHR IHW IMI INH INR IOF IPO ITC IX1 J0M K48 KBYEO L7B LATKE LC2 LC4 LEEKS LH4 LITHE LOXES LP6 LP7 LUTES LW6 LYRES MEWTI MK0 MK4 MRFUL MRMAN MRSSH MSFUL MSMAN MSSSH MXFUL MXMAN MXSSH N04 N06 N4W N95 N9A NF~ O66 O9- OIG OK1 OVD P2P P2W P2Y P2Z P4B P4C PQQKQ PV9 Q.N Q11 QB0 R.K RIG ROL RPM RWL RX1 RXW RZL SUPJJ SV3 TAF TEORI TR2 TUS U5U UB1 V8K VH1 W8V W99 WBKPD WH7 WHWMO WIH WII WIJ WOHZO WOW WQZ WRC WVDHM WXI WXSBR XG1 XI7 XOL YUY YXB YYQ Z0Y ZGI ZXP ZZTAW ~IA ~WP AAMMB AAYXX AEFGJ AEYWJ AGHNM AGQPQ AGXDD AIDQK AIDYY BAIFH BBTPI CITATION O8X CGR CUY CVF ECM EIF NPM 7QJ K9. 7X8 5PM |
| ID | FETCH-LOGICAL-c4233-4962a9e60d95e3939d27e4b6ebeece41e7ef9b798c45768dd4d14e4a734449103 |
| IEDL.DBID | DRFUL |
| ISICitedReferencesCount | 0 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=001058796700001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 0017-9124 1475-6773 |
| IngestDate | Tue Nov 04 02:04:25 EST 2025 Sun Sep 28 02:49:57 EDT 2025 Sat Nov 08 00:01:51 EST 2025 Sun Aug 03 01:52:30 EDT 2025 Sat Nov 29 05:40:14 EST 2025 Wed Jan 22 17:18:15 EST 2025 |
| IsDoiOpenAccess | false |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 4 |
| Keywords | tiered provider networks vertical integration horizontal consolidation market competition |
| Language | English |
| License | 2023 Health Research and Educational Trust. |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c4233-4962a9e60d95e3939d27e4b6ebeece41e7ef9b798c45768dd4d14e4a734449103 |
| Notes | Elizabeth Bambury is currently a Data Analyst at Aptihealth. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 |
| ORCID | 0000-0003-4230-1947 0000-0001-9947-4094 0000-0003-3410-0184 |
| OpenAccessLink | https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/1475-6773.14223 |
| PMID | 37670453 |
| PQID | 3080881939 |
| PQPubID | 41644 |
| PageCount | 7 |
| ParticipantIDs | pubmedcentral_primary_oai_pubmedcentral_nih_gov_11250427 proquest_miscellaneous_2861646003 proquest_journals_3080881939 pubmed_primary_37670453 crossref_primary_10_1111_1475_6773_14223 wiley_primary_10_1111_1475_6773_14223_HESR14223 |
| PublicationCentury | 2000 |
| PublicationDate | August 2024 |
| PublicationDateYYYYMMDD | 2024-08-01 |
| PublicationDate_xml | – month: 08 year: 2024 text: August 2024 |
| PublicationDecade | 2020 |
| PublicationPlace | Oxford, UK |
| PublicationPlace_xml | – name: Oxford, UK – name: United States – name: Chicago |
| PublicationTitle | Health services research |
| PublicationTitleAlternate | Health Serv Res |
| PublicationYear | 2024 |
| Publisher | Blackwell Publishing Ltd |
| Publisher_xml | – name: Blackwell Publishing Ltd |
| References | 2021; 7 2021; 27 2021; 10 2012 2022; 81 2017; 36 2022 2020 2019 2017 2022; 41 2016; 50 2020; 12 e_1_2_7_6_1 e_1_2_7_5_1 Center for Health Information and Analysis (e_1_2_7_11_1) 2017 e_1_2_7_4_1 e_1_2_7_3_1 e_1_2_7_8_1 Mazurenko O (e_1_2_7_7_1) 2021; 10 The Kaiser Family Foundation and Health Research Educational Trust (e_1_2_7_2_1) 2019 e_1_2_7_16_1 RAND (e_1_2_7_18_1) 2022 e_1_2_7_15_1 e_1_2_7_14_1 e_1_2_7_13_1 Waters R (e_1_2_7_17_1) 2020 Gudiksen KL (e_1_2_7_10_1) 2020 e_1_2_7_12_1 Commonwealth of Massachusetts (e_1_2_7_9_1) 2012 |
| References_xml | – volume: 12 start-page: 196 issue: 4 year: 2020 end-page: 223 article-title: Healthcare demand under simple prices: evidence from tiered hospital networks publication-title: Am Econ J Appl Econ – volume: 50 start-page: 1 year: 2016 end-page: 8 article-title: The effect of hospital/physician integration on hospital choice publication-title: J Health Econ – year: 2022 – volume: 10 start-page: 607 year: 2021 end-page: 617 article-title: The impact of narrow and tiered networks on costs, access, quality, and patient steering: a systematic review publication-title: Med Care Res Rev – year: 2020 – volume: 81 year: 2022 article-title: Treatment consolidation after vertical integration: evidence from outpatient procedure markets publication-title: J Health Econ – volume: 41 start-page: 741 issue: 5 year: 2022 end-page: 750 article-title: Price effects of vertical integration and joint contracting between physicians and hospitals In Massachusetts publication-title: Health Aff – volume: 7 start-page: 306 issue: 3 year: 2021 end-page: 332 article-title: Tiered cost‐sharing for primary care gatekeeper clinics publication-title: Am J Health Econ – volume: 36 start-page: 870 issue: 5 year: 2017 end-page: 875 article-title: Enrollment in a health plan with a tiered provider network decreased medical spending by 5 percent publication-title: Health Aff – year: 2017 – article-title: Deciphering Sutter Health's State‐Court Settlement and Federal‐Court Win In Parallel Antitrust Cases publication-title: Health Aff Forefront – year: 2019 – volume: 27 start-page: e316 issue: 9 year: 2021 end-page: e321 article-title: Clinic price reductions in a tiered total cost benefit design publication-title: Am J Manag Care – year: 2012 – volume-title: Preventing Anticompetitive Contracting Practices in Healthcare Markets year: 2020 ident: e_1_2_7_10_1 – volume: 10 start-page: 607 year: 2021 ident: e_1_2_7_7_1 article-title: The impact of narrow and tiered networks on costs, access, quality, and patient steering: a systematic review publication-title: Med Care Res Rev – ident: e_1_2_7_16_1 – ident: e_1_2_7_15_1 doi: 10.1016/j.jhealeco.2021.102569 – volume-title: Performance of the Massachusetts Health Care System year: 2017 ident: e_1_2_7_11_1 – volume-title: California's Sutter Health Settlement: What States Can Learn About Protecting Residents from the Effects of Health Care Provider Consolidation year: 2020 ident: e_1_2_7_17_1 – volume-title: 2019 Employer Health Benefits Survey year: 2019 ident: e_1_2_7_2_1 – volume-title: Environmental Scan on Consolidation Trends and Impacts in Health Care Markets year: 2022 ident: e_1_2_7_18_1 – volume-title: An Act Improving the Quality of Health Care and Reducing Costs Through Increased Transparency, Efficiency and Innovation year: 2012 ident: e_1_2_7_9_1 – ident: e_1_2_7_8_1 doi: 10.1377/forefront.20220509.99893 – ident: e_1_2_7_5_1 doi: 10.37765/ajmc.2021.88744 – ident: e_1_2_7_13_1 doi: 10.1377/hlthaff.2021.00727 – ident: e_1_2_7_6_1 doi: 10.1377/hlthaff.2016.1087 – ident: e_1_2_7_12_1 – ident: e_1_2_7_14_1 doi: 10.1016/j.jhealeco.2016.08.006 – ident: e_1_2_7_3_1 doi: 10.1257/app.20180422 – ident: e_1_2_7_4_1 doi: 10.1086/714360 |
| SSID | ssj0008384 |
| Score | 2.4209282 |
| Snippet | Objective
To understand variation in enrollment in tiered network health plans (TNPs) and the local provider market characteristics associated with TNP... To understand variation in enrollment in tiered network health plans (TNPs) and the local provider market characteristics associated with TNP penetration. We... ObjectiveTo understand variation in enrollment in tiered network health plans (TNPs) and the local provider market characteristics associated with TNP... To understand variation in enrollment in tiered network health plans (TNPs) and the local provider market characteristics associated with TNP... |
| SourceID | pubmedcentral proquest pubmed crossref wiley |
| SourceType | Open Access Repository Aggregation Database Index Database Publisher |
| StartPage | e14223 |
| SubjectTerms | Employees Employers Enrollments Extraction Health Benefit Plans, Employee - statistics & numerical data Health care industry Health insurance horizontal consolidation Insurance market competition Market concentration Markets Massachusetts Networks Occupational health Penetration Physicians Research Brief State employees tiered provider networks vertical integration Vertical penetration |
| Title | Variation in tiered network health plan penetration and local provider market characteristics |
| URI | https://onlinelibrary.wiley.com/doi/abs/10.1111%2F1475-6773.14223 https://www.ncbi.nlm.nih.gov/pubmed/37670453 https://www.proquest.com/docview/3080881939 https://www.proquest.com/docview/2861646003 https://pubmed.ncbi.nlm.nih.gov/PMC11250427 |
| Volume | 59 |
| WOSCitedRecordID | wos001058796700001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| journalDatabaseRights | – providerCode: PRVWIB databaseName: Wiley Online Library Full Collection 2020 customDbUrl: eissn: 1475-6773 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0008384 issn: 0017-9124 databaseCode: DRFUL dateStart: 20020101 isFulltext: true titleUrlDefault: https://onlinelibrary.wiley.com providerName: Wiley-Blackwell |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV1LT9wwEB7BUiEkBBQKBChyJQ69pCSxN7aPCFjtYYsQL-2lipzYESsVs2KX_v6O7SRiy6Gq1Fsk52XP67M98xngRGtHysIUWpoSMdOsjlUiTFxmRpaoQ2ldesr8Eb-6EuOxvG6yCV0tTOCH6BbcnGV4f-0MXJWzN0aeMu7S5jn95pYx6DKsZKi9_R6sXNwM7kedOxZUsNYdS4xmDb-PS-f54xWLoekd3nyfNvkWzvp4NNj8Dz3Zgo0GjJKzoD0fYcnYbVj93my3b8N6WNQjoVZpB3484Mzai5JMLJlP3DmfxIZEchIqKsn0p7Jkih604eMlymriIyZpq_7Iky-1JtUiWfQnuB9c3p0P4-Z8hrhCEEZjJvNMSZMnWvYNlVTqjBtW5qgXpjIsNdzUsuRSVMzNarRmOmWGKU4ZYwhT6C707LM1-0CqWquclzrt14jPqFS5qKUSOimzOpF1EsHXVjTFNNBwFO30xQ1f4Yav8MMXwVEruqKxx1lBERgLBD9URvCla0ZLctsjyprn11mRidyRraGbi2AvSLr7luO8QfCLLWJBB7obHEv3YoudPHq2bgS0fXegSQSnXgn-9v_F8PL2xl8d_PMTh7CWIegKCYpH0Ju_vJrP8KH6NZ_MXo5hmY_FcWMfvwFuaA47 |
| linkProvider | Wiley-Blackwell |
| linkToHtml | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV3NT9swFH_aYBpIaAw2IAw2T-KwS1gSu4l9RIyq00oPDBCXyXJiR6sEbkXL_v4920nUjgNC2i2S8-n39fPLez8DHGntSFmYQktTPGaa1bFKuInLzIgSdSitS0-ZPyxGI35zIxZ7YQI_RJdwc5bh_bUzcJeQXrDylBWubr6gxy6PQV_CKkNlQi1f_XbRvxp2_phTzlp_LDCcNQQ_rp7nn1ssx6ZHgPNx3eQinvUBqb_5Pz7lLbxp4Cg5CfqzBS-M3YbX580P923YCGk9ErqV3sGva1xbe2GSsSXzsdvpk9hQSk5CTyWZ3ipLpuhDG0ZeoqwmPmaStu-P3Plma1It00W_h6v-2eXpIG52aIgrhGE0ZiLPlDB5okXPUEGFzgrDyhw1w1SGpaYwtSgLwSvm1jVaM50yw1RBGWMIVOgOrNiJNXtAqlqrvCh12qsRoVGhcl4LxXVSZnUi6iSCL61s5DQQcch2AeOmT7rpk376IjhoZScbi5xJitCYI_yhIoLP3TDakvtBoqyZPMxkxnNHt4aOLoLdIOruWY71BuEvjvAlJehOcDzdyyN2_NvzdSOk7bktTSL46rXgqfeXg7OfF_5o_9lXfIK1weX5UA6_j358gPUMIVgoVzyAlfn9gzmEV9Wf-Xh2_7Exk79B3hFD |
| linkToPdf | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV1LT9wwEB7RpUKVELT0QSi0rtRDL6FJ7E3sIwJWVN2uKloqLpXlxLa6UmtW7NLf37GdRLvlgJC4RXKe8_JnZ-YbgPdae1IWptDTFE-ZZjZVGTdpXRhRow3ltg6U-eNqMuGXl2K5FibyQ_Qbbt4zQrz2Dm5m2i55ec4qnzdf0UO_j0EfwTrzrWQGsH5yProY9_GYU866eCxwOmsJfnw-z3-3WJ2bbgHO23mTy3g2TEij7Yf4lKew1cJRchTt5xmsGbcDG1_aH-47sBm39UisVnoOP3_g2jook0wdWUx9p0_iYio5iTWVZPZbOTLDGNoy8hLlNAlzJunq_sifUGxNmlW66BdwMTr9fnyWth0a0gZhGE0ZylsJU2ZaDA0VVOiiMqwu0TJMY1huKmNFXQneML-u0ZrpnBmmKsoYQ6BCX8LAXTmzC6SxWpVVrfOhRYRGhSq5FYrrrC5sJmyWwIdON3IWiThkt4Dx4pNefDKIL4H9Tney9ci5pAiNOcIfKhJ41w-jL_kfJMqZq5u5LHjp6dYw0CXwKqq6f5ZnvUH4iyN8xQj6EzxP9-qIm_4KfN0IaYe-pUkCH4MV3PX-8uz023k42rv3FW9h4-vJSI4_TT6_hicFIrCYrbgPg8X1jTmAx83fxXR-_ab1kn-zHhC- |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Variation+in+tiered+network+health+plan+penetration+and+local+provider+market+characteristics&rft.jtitle=Health+services+research&rft.au=Sinaiko%2C+Anna+D&rft.au=Curto%2C+Vilsa+E&rft.au=Bambury%2C+Elizabeth&rft.au=Soto%2C+Mark+J&rft.date=2024-08-01&rft.issn=1475-6773&rft.eissn=1475-6773&rft.volume=59&rft.issue=4&rft.spage=e14223&rft_id=info:doi/10.1111%2F1475-6773.14223&rft.externalDBID=NO_FULL_TEXT |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0017-9124&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0017-9124&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0017-9124&client=summon |