Dive Brief:
-
A new study published on The JAMA Network found that total Medicare spending and utilization of services were higher for patients whose doctors have more connections to other physicians and more shared care outside of their network.
-
The study also found that patients whose physicians’ networks included more primary care physicians saw more primary care visits and fewer specialists and emergency visits.
-
The researchers said “characteristics of physicians’ networks and the position of physicians and hence their patients within the network are associated with overall spending and utilization of services for Medicare beneficiaries.”
Dive Insight:
The researchers studied how physicians’ “informal networks” are associated with healthcare spending, utilization and quality of care for Medicare beneficiaries.They analyzed Medicare administrative data from 2006 to 2010 for an average of more than 3.7 million Medicare beneficiaries per year. The beneficiaries were seen by more than 40,000 physicians practicing in 51 hospital referral regions.
The study found the mean total annual spending per patient was $10,051. The total was higher for patients of physicians with more connections to other physicians and more shared care outside of their community. Inpatient care spending was slightly lower for patients whose physicians’ communities had higher proportions of primary care physicians.
Patients whose physicians were linked to more physicians also had more hospital admissions and days, more emergency visits, more visits to specialists and more primary care visits.
The study results are a lesson in how more physician connections, especially ones that are outside of the network, can lead to more healthcare spending and utilization. Usually, larger informal physician networks are seen as a positive for patients who seek multiple options for their care. However, this Medicare study shows that luxury often comes at a cost.