Altarum's Private Insurance Research Collection

Commissioned Projects

Narrow Provider Networks and the Access to and the Utilization of Primary and Behavioral Health Care Services for Racial and Ethnic Minorities, Ryan McKenna, Drexel School of Public Health

Persistent barriers to access and utilization of health care have contributed to long-standing health disparities for racial and ethnic minorities in the United States (US). The Patient Protection and Affordable Care Act’s (ACA) insurance expansion has reduced disparities in health insurance coverage for these groups by allowing states to expand Medicaid eligibility and establishing insurance marketplaces with premium supports. However, potential barriers to care, such as narrow provider networks (NPN), stand to hinder the ability of the insurance expansion to result in reductions in disparities in health care access and utilization. The premise of this study is that, while NPNs can result in high-value care, little is known about the extent to which NPNs may limit access and utilization of primary and specialty care. Given that racial and ethnic minorities and the medically underserved have been disproportionately helped by the ACA’s insurance expansion, they stand to be the most affected by the adverse consequences of NPNs. Aim 1 is to determine the strength of the association between network breadth and measures of primary care and behavioral health access and utilization outcomes for marketplace enrollees. Aim 2 is to determine the extent to which NPNs contribute to the increase or reduction of racial and ethnic disparities in primary and behavioral health care access and utilization.