A 2024 awarded grant under the Robert Wood Johnson Foundation’s Health Data for Action program, managed by AcademyHealth.
This project is funded under the Robert Wood Johnson Foundation’s research program, “Health Data for Action (HD4A),” which makes valuable data from unique data owners available to researchers to answer important research questions. The study uses Medicare Advantage Encounter and Enrollment data to study ghost networks in Medicare Advantage -- that is, where there is a difference between the advertised listing of “in-network” providers for a given MA plan, and the realized network of providers delivering care to plan-enrolled beneficiaries. The study aims are to quantify the depth and breadth of ghost networks in MA, identify enrollees with greater exposure to ghost networks, and to explore whether ghost networks reflect preferences for higher quality providers. This study will provide timely and critical information about plan-to-plan variation within MA. Deliverables will include a project work plan, final narrative, and financial reports. The researcher will also produce paper(s) suitable for publication and present findings at national research meetings and to other stakeholder audiences as appropriate, including policymakers at the federal, state, and local levels and other key stakeholders, as part of the deliverables for this grant.
Grant #82516
Grantee Organization: University of Maryland, College Park School of Public Health
Grantee Period: 11/15/24 – 11/14/26
Mika K. Hamer is a health services researcher, Assistant Professor in the University of Maryland School of Pub... Read Bio