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  • Title: Do specialist self-referral insurance policies improve access to HIV-experienced physicians as a regular source of care?
    Author: Heslin KC, Andersen RM, Ettner SL, Kominski GF, Belin TR, Morgenstern H, Cunningham WE.
    Journal: Med Care Res Rev; 2005 Oct; 62(5):583-600. PubMed ID: 16177459.
    Abstract:
    Health insurance policies that require prior authorization for specialty care may be detrimental to persons with HIV, according to evidence that having a regular physician with HIV expertise leads to improved patient outcomes. The objective of this study is to determine whether HIV patients who can self-refer to specialists are more likely to have physicians who mainly treat HIV. The authors analyze cross-sectional survey data from the HIV Costs and Services Utilization Study. At baseline, 67 percent of patients had insurance that permitted self-referral. In multivariate analyses, being able to self-refer was associated with an 8-12 percent increased likelihood of having a physician at a regular source of care that mainly treats patients with HIV. Patients who can self-refer are more likely to have HIV-experienced physicians than are patients who need prior authorization. Insurance policies allowing self-referral to specialists may result in HIV patients seeing physicians with clinical expertise relevant to HIV care.
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