Consumers unhappy to see fewer, more expensive PPO plans on ACA exchanges

Not only are there fewer preferred provider organization (PPO) plans on the health insurance exchanges in 2016, those plans are also pricier. And some consumers are not happy about this trend, according to a Kaiser Health News report.

While PPOs have been a popular choice for consumers because they offer more freedom in choosing physicians and hospitals, there's fewer of these plans on the insurance marketplaces in 2016 and the premiums are rising faster for those type plans than for other types of coverage, KHN reports.

A KHN analysis found that the average premium for the least expensive silver plans for a PPO jumped 17 percent, while those for closed network plans, primarily health maintenance organizations (HMOs), saw only a 9 percent increase.

PPOs offer consumers flexibility as they pay for a portion of the costs of out-of-network providers. In Houston, for instance, the only plans offered through the federal exchange in 2016 have so-called narrow networks. "Everyone is up in arms," Jo Middleton, a Houston insurance broker, told KHN. "I do not have a single client who is happy. They want PPOs and can't get them. They want the flexibility."

Consumers are complaining the HMOs on the exchange offer networks that are too small and don't include all of the physicians, specialists or hospitals they want access to. For example, none of the plans available through the federal exchange in Houston include access to Houston's MD Anderson Cancer Center. However, availability of PPOs depends on where consumers live. Three states--Alaska, Arkansas and Wyoming--actually only offer PPOs, according to the report.

As Katherine Hempstead, who directs coverage issues at the Robert Wood Johnson Foundation (RWJF), previously told FierceHealthPayer, overall there are fewer PPOs because insurers were losing money on them. An analysis from RWJF found that two-thirds of insurance companies that offered PPO plans last year on the exchanges have either reduced or stopped offering them.

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