Research Report Narrow Provider Networks in New Health Plans
Subtitle
Balancing Affordability with Access to Quality Care
Sabrina Corlette, JoAnn Volk, Robert A. Berenson
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Consumers choosing health insurance plans inside and outside the new marketplaces may face a tradeoff: narrower provider networks may lower premiums, but they may also limit access to care or increase out-of-pocket costs. This policy brief assesses the benefits and risks of policy options open to federal and state policymakers now reviewing requirements for plans' network adequacy. The authors find that no single policy can achieve the appropriate balance between insurers' flexibility to negotiate with providers and consumers' confidence that plans will deliver on promised benefits. Accordingly, the authors call on policymakers to protect consumers with a combination of regulatory standards, up-to-date information to facilitate consumer choices, and active monitoring of plans' actual performance.
Research Areas Health and health care
Tags Health insurance Health care delivery and payment Health care systems and managed care plans
Policy Centers Health Policy Center