Insurance Acceptance, Appointment Wait Time, and Dermatologist Access Across Practice Types in the US
| Autor: | Sara J. Li, Kira Seiger, Arash Mostaghimi, Guohai Zhou, Sheena Desai, Karen J. Lee, Jack S. Resneck, Ai-Tram N. Bui, Camila Villa-Ruiz, Andrew Creadore, Cara Joyce, Kelly Lo |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Waiting time
medicine.medical_specialty Time Factors Waiting Lists Insurance type Dermatology Medicare Health Services Accessibility 030207 dermatology & venereal diseases 03 medical and health sciences Appointments and Schedules 0302 clinical medicine Insurance types Interquartile range medicine Humans health care economics and organizations Original Investigation Insurance Health business.industry Medicaid Preferred provider organization Wait time United States Cross-Sectional Studies 030220 oncology & carcinogenesis Private Sector business Dermatologists |
| Zdroj: | JAMA Dermatol |
| ISSN: | 2168-6084 |
| Popis: | IMPORTANCE: In the 15 years since dermatology access was last investigated on a national scale, the practice landscape has changed with the rise of private equity (PE) investment and increased use of nonphysician clinicians (NPCs). OBJECTIVE: To determine appointment success and wait times for patients with various insurance types at clinics with and without PE ownership. DESIGN, SETTING, AND PARTICIPANTS: In this study, PE-owned US clinics were randomly selected and matched with 2 geographically proximate clinics without PE ownership. Researchers called each clinic 3 times over a 5-day period to assess appointment/clinician availability for a fictitious patient with a new and changing mole. The 3 calls differed by insurance type specified, which were Blue Cross Blue Shield (BCBS) preferred provider organization, Medicare, or Medicaid. MAIN OUTCOMES AND MEASURES: Appointment success and wait times among insurance types and between PE-owned clinics and control clinics. Secondary outcomes were the provision of accurate referrals to other clinics when appointments were denied and clinician and next-day appointment availability. RESULTS: A total of 1833 calls were made to 204 PE-owned and 407 control clinics without PE ownership across 28 states. Overall appointment success rates for BCBS, Medicare, and Medicaid were 96%, 94%, and 17%, respectively. Acceptance of BCBS (98.5%; 95% CI, 96%-99%; P = .03) and Medicare (97.5%; 95% CI, 94%-99%; P = .02) were slightly higher at PE-owned clinics (compared with 94.6% [95% CI, 92%-96%] and 92.8% [95% CI, 90%-95%], respectively, at control clinics). Wait times (median days, interquartile range [IQR]) were similar for patients with BCBS (7 days; IQR, 2-22 days) and Medicare (7 days; IQR, 2-25 days; P > .99), whereas Medicaid patients waited significantly longer (13 days; IQR, 4-33 days; P = .002). Clinic ownership did not significantly affect wait times. Private equity–owned clinics were more likely than controls to offer a new patient appointment with an NPC (80% vs 63%; P = .001) and to not have an opening with a dermatologist (16% vs 6%; P |
| Databáze: | OpenAIRE |
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