Narrow Networks On The Health Insurance Marketplaces: Prevalence, Pricing, And The Cost Of Network Breadth

Anecdotal reports and systematic research highlight the prevalence of narrow-network plans on the Affordable Care Act's health insurance Marketplaces. At the same time, Marketplace premiums in the period 2014-16 were much lower than projected by the Congressional Budget Office in 2009. Using de...

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Vydáno v:Health Affairs Ročník 36; číslo 9; s. 1606 - 1614
Hlavní autoři: Dafny, Leemore S., Hendel, Igal, Marone, Victoria, Ody, Christopher
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States The People to People Health Foundation, Inc., Project HOPE 01.09.2017
Témata:
Budgets
Computer networks
Confounding factors
Cost control
Cost Savings - economics
Costs and Cost Analysis - economics
Economics
Health care
Health care expenditures
Health care industry
Health care policy
Health insurance
Health Insurance Exchanges - economics
Health maintenance organizations
Health services
HMOs
Humans
Insurance
Insurance coverage
Insurance Coverage - economics
Insurance premiums
Insurance, Health - economics
Internet
Markets
Networks
Patient Protection & Affordable Care Act 2010-US
Patient Protection and Affordable Care Act - economics
Physicians
Physicians - supply & distribution
Premiums
Prices
State employees
Subsidies
United States
Insurance Market < Insurance
Health Economics
Health Reform
ISSN:0278-2715, 2694-233X, 1544-5208, 2694-233X
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Shrnutí:Anecdotal reports and systematic research highlight the prevalence of narrow-network plans on the Affordable Care Act's health insurance Marketplaces. At the same time, Marketplace premiums in the period 2014-16 were much lower than projected by the Congressional Budget Office in 2009. Using detailed data on the breadth of both hospital and physician networks, we studied the prevalence of narrow networks and quantified the association between network breadth and premiums. Controlling for many potentially confounding factors, we found that a plan with narrow physician and hospital networks was 16 percent cheaper than a plan with broad networks for both, and that narrowing the breadth of just one type of network was associated with a 6-9 percent decrease in premiums. Narrow-network plans also have a sizable impact on federal outlays, as they depress the premium of the second-lowest-price silver plan, to which subsidy amounts are linked. Holding all else constant, we estimate that federal subsidies would have been 10.8 percent higher in 2014 had Marketplaces required all plans to offer broad provider networks. Narrow networks are a promising source of potential savings for other segments of the commercial insurance market.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0278-2715
2694-233X
1544-5208
2694-233X
DOI:10.1377/hlthaff.2016.1669