Although narrow network plans, which are commonly sold on the health insurance exchanges, offer far fewer hospitals and doctors for consumers to choose from, they still deliver similar or better quality care as other plans, according to a study published in Health Affairs.
The study's authors analyzed hospital networks provided by the largest insurers in California--Anthem Blue Cross, Blue Shield of California, Health Net and Kaiser Permanente--and compared them by plan types and geographical region. They considered plans sold both on the state's exchange, Covered California, as well as in the commercial market.
They confirmed that exchange plans generally have fewer hospitals in-network than employer-sponsored plans. But in contrast to the concerns of many lawmakers and the public, they also determined that narrow networks still offer quality care. What's more, the study supports what insurers have been saying for years: Narrow networks can substantially lower costs.
"Our analyses paint a somewhat surprising picture of the difference in the average quality of hospitals in these networks," the study authors wrote. "The average quality in the [Covered California] networks is actually higher than that in the commercial networks."
Although consumers enrolled in exchange plans can choose from a smaller pool of hospitals to receive care, the narrow networks "only marginally restrict geographic access as measured by the percentage of people residing in at least one hospital market area," the authors said.
California officials have been among the nation's leaders in investigating narrow networks, FierceHealthPayer has reported. And in two separate lawsuits, Consumer Watchdog sued Cigna and Blue Shield of California, claiming they offered inadequate provider networks and incorrectly advertised which providers were in their networks.
To learn more:
- here's the Health Affairs study