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Patients Select Fewer New Docs at Bottom of Tiered Ranking

Tiered networks combined with payment-based reforms can improve performance, authors say

MONDAY, April 7, 2014 (HealthDay News) -- Patients are less likely to select a new physician ranked in the bottom of a tiered network, but often don't switch if their current physician is ranked at the bottom, according to research published online March 11 in Health Services Research.

Anna D. Sinaiko, Ph.D., and Meredith B. Rosenthal, Ph.D., both from Harvard University in Boston, estimated the impact of tier rankings on physician market share among both a plan of new patients and on the percent of a physician's patients who switch to other physicians.

The researchers found that physicians in the bottom tier (least-preferred), particularly certain specialists, had a lower market share of new patient visits than physicians with higher tier rankings. Patients were more likely to switch health plans if their physician was in the bottom tier, but patients did not switch away from physicians whom they'd previously seen based on tier ranking.

"The effect of tiering appears to be among patients who choose new physicians and at the lower end of the distribution of tiered physicians, rather than moving patients to the 'best' performers," the authors write.

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