Payer Network Map

Determining whether provider networks provide sufficient access

Dr. Thomas Concannon can help payers determine whether their provider networks provide sufficient access to care. He can estimate the travel times that patients in various census tracts experience while journeying to providers, enabling payers to better understand whether in-network providers and ACOs are adequately accessible to all of their members. For services covered by the Health Care Cost and Utilization Project’s (HCUP) State Inpatient Databases (SID), Dr. Concannon can go a step further and determine how access to care varies throughout the day, as not all hospitals provide all services 24/7. All of this information can be used to create more comprehensive networks that reduce members’ need to seek services from providers whose rates have not been negotiated.

The techniques that Dr. Concannon has employed can be used to analyze access to care for many different services in various markets. His method revolves around combining information from the American Hospital Association Annual Survey Database and the Health Care Cost and Utilization Project’s (HCUP) State Inpatient Databases (SID). Although Dr. Concannon’s original research examined access to Percutaneous Coronary Intervention, the technique that he used can easily be extended to a multitude of other services whose presence is indicated in these two databases. Payers can benefit from having a better understanding of which geographic locations are underserved and over served by particular services, as they can use the information to design networks providing adequate geographic reach. Furthermore, the information may be used to understand the degree to which various providers have monopolies on services in different geographic areas.

Dr. Concannon’s research on access to care in the context of Percutaneous Coronary Intervention was published in the journal Circulation: Cardiovascular Quality and Outcomes. In addition, Dr. Concannon published an article in JAMA that analyzed access to burn care centers using similar techniques, demonstrating the diverse potential applications of his geospatial analysis. Dr. Concannon’s perspectives have also been featured in popular publications including The New York Times, U.S. News and World Report, and The Washington Post.