Association of Inadequate Provider Networks with Unmet Need for Health Services and Self-Employment among People with Disabilities

People with disabilities (PWD) make up over a quarter of the U.S. population and often have complex medical needs. Insurance plans with narrow provider networks are growing in popularity despite concerns about limiting access to care, which may detrimentally affect PWD. This study used logistic regression to assess the relationship between inadequate networks and unmet health care needs and employment using the 2018 National Survey on Health and Disability (n= 1,009) adjusting for demographic and health factors. Having an inadequate network was associated with unmet needs (OR=5.56, 95%CI[3.33,9.28]) but not being employed for wages (OR=0.70, 95%CI[0.42,1.17]) or self-employed (OR=2.35, 95%CI[0.99,5.55]). There was an association between an inadequate network and self-employment for those with good health (OR=3.37, 95%CI[1.19,9.57]). Providers for PWD should be aware of the role insurance quality can play in health outcomes. Policymakers should continue to monitor the impact of provider network adequacy on health outcomes.