Provider directory inaccuracy and timely access to physical therapy

Abstract

Can patients find physical therapists in their networks, and can they access physical therapy when they need to? To answer these questions, we analyzed provider directory accuracy and timely access for physical therapists for all managed care plans available in California in 2018 and 2019 using secondary data obtained from the California Department of Managed Health Care for a total of 119,084 physical therapy listings (60,967 for 2018 and 58,117 for 2019). Overall, 19% of listed providers in 2018 and 8% of listed providers in 2019 showed inaccuracies. However, we found substantial differences across markets, with a low of 54% accuracy for Medicaid listings in 2018. Commercial plans were consistently most accurate. In terms of adequacy, we found that more than 90% of listed providers were accessible within 15 days and 97% within 30 days, with Medicaid providing the highest rates of timely access. Overall, barriers to consumer access with regard to physical therapy appear to be primarily in the form of provider directory inaccuracies. High rates of inaccuracies raise concerns for patients as well as regulators. Ultimately, California is one of the most regulated states when it comes to network adequacy and access.