期刊
AMERICAN JOURNAL OF MANAGED CARE
卷 29, 期 2, 页码 96-+出版社
MANAGED CARE & HEALTHCARE COMMUNICATIONS LLC
DOI: 10.37765/ajmc.2023.89318
关键词
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This study aimed to evaluate the accuracy of provider directories for mental health providers and network adequacy in California. The findings showed that mental health provider directories are highly inaccurate and there are limitations in providing timely access to appointments. These findings are concerning and indicate the need to further protect consumers.
OBJECTIVES: To evaluate the accuracy of provider directories for mental health providers and network adequacy, defined as timely access to urgent and general care appointments in California.STUDY DESIGN: We assessed provider directory accuracy and timely access using a novel, comprehensive, and representative data set of mental health providers for all plans regulated by the California Department of Managed Health Care with 1,146,954 observations (480,013 for 2018 and 666,941 for 2019).METHODS: We used descriptive statistics to assess provider directory accuracy and network adequacy assessed via access to timely appointments. We used t tests to make comparison across markets.RESULTS: We found that mental health provider directories are highly inaccurate. Commercial plans were consistently more accurate than both Covered California marketplace and Medi-Cal plans. Moreover, plans were highly limited in providing timely access to urgent care and general appointments, although Medi-Cal plans outperformed plans from both other markets when it came to timely access.CONCLUSIONS: These findings are concerning from both the consumer and regulatory perspectives and provide further evidence of the tremendous challenge that consumers face in accessing mental health care. Although California's laws and regulations are some of the strongest in the country, they are still falling short, indicating the need to further expand efforts to protect consumers.
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