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Provider Networks

Latest Headlines

Latest Headlines

Proposed rules target Medicare Advantage network changes

Following UnitedHealth's controversial move to drop 19 percent of its Medicare Advantage network, new rules call for insurers to give members and providers more notice of major network changes and terminations,  Kaiser Health News  and the  Washington Post  reported.

Provider networks exclude some top cancer centers

Provider networks on insurance exchanges exclude some of the nation's best cancer hospitals, which concerns some state insurance regulators and patient advocates.

New health plan accreditation rules would scrutinize narrow networks

The National Committee for Quality Assurance wants to overhaul its health plan accreditation program to better align with market and stakeholders needs. With that in mind, the proposed changes focus on provider networks and transparency.

Expensive plans don't mean large provider networks

The highest priced plans available on a health insurance exchange don't necessarily have the best benefits, says a new analysis from the U.S. News & World Report.

Insurers struggle to set 2015 prices amid unknown factors

Insurers are struggling to set 2015 prices for exchange plans because some of the most essential aspects that factor into their decisions remain unknown.

How to form high-quality narrow networks

Despite public controversy over narrow networks, plans with smaller networks aren't necessarily bad, according to Ezekiel Emanuel, a former White House health adviser who helped design the Affordable Care Act.

Narrow networks remain controversial despite promise of cost control

To compete on premium price in a post healthcare-reform market, insurers need to reduce the amount they pay providers for services delivered to members, according to a Health Affairs blog post. Payers have been turning to controversial narrow provider networks to do this--using the most cost-efficient providers or offering provider rebates linked to the medical-loss ratio.

Doc group wants tighter restrictions for narrow networks

The Centers for Medicare & Medicaid Services and state regulators should guarantee that insurers don't choose which providers to include within their networks solely based on costs, the American College of Physicians (ACP) said Tuesday in its annual report on the state of healthcare.

Docs can challenge UnitedHealth's Medicare Advantage cuts, court rules

A federal appeals court has denied UnitedHealthcare's request to dismiss a lawsuit brought by doctor associations in Connecticut. The case is part of a larger trend of  providers fighting back when insurers drop them from networks. 

Hospital contests removal from provider network

Frisbie Memorial Hospital in Rochester, N.H., one of 10 hospitals ousted from Anthem Blue Cross Blue Shield's provider network for individual health plans, is fighting to rejoin the ranks of participating providers, the Associated Press reported.