Oncology Organization and Oncologist Networks Under Medicare Advantage Plans

What is the effective oncology organization and oncologist network breadth in Medicare Advantage (MA) plans based on realized health care utilization?Using 2016-2019 Surveillance, Epidemiology, and End Results–Medicare data of 23 255 regular MA plan-years and 17 716 special needs plan-years for 807 580 MA enrollees, this cross-sectional study found that beneficiaries accessed approximately 12% of oncology organizations, 7% of medical or surgical oncologists, and 12% of radiation oncologists vs Traditional Medicare beneficiaries. Fewer than one-quarter of MA plans covered National Cancer Institute–designated comprehensive cancer centers, and effective networks were narrower in HMOs and nonmetropolitan areas.These findings suggest constrained effective oncology networks may limit access to specialized cancer care; research on the potential implications of constrained networks for cancer outcomes is warranted.

Corresponding Author: Xin Hu, PhD, Department of Radiation Oncology, School of Medicine, Emory University, 1365 Clifton Rd NE, C3005, Atlanta, GA 30322 (xin.hu@emory.edu).

Link to the article in your story

We encourage you to link out to this article in your story using the link below. It includes an access token that will give free access to the article for your readers up to one year after publication. (The link will be live after the article publishes and embargo is lifted.)

Please see the article for additional information, including full author list, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

Need more information? Contact us.