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 |
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| Jazyk: | angličtina |
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United States
The People to People Health Foundation, Inc., Project HOPE
01.09.2017
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| ISSN: | 0278-2715, 2694-233X, 1544-5208, 2694-233X |
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| Abstract | 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. |
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| AbstractList | 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.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. 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. 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. |
| Author | Dafny, Leemore S. Hendel, Igal Ody, Christopher Marone, Victoria |
| Author_xml | – sequence: 1 givenname: Leemore S. surname: Dafny fullname: Dafny, Leemore S. organization: Leemore S. Dafny is the Bruce V. Rauner Professor of Business Administration at Harvard Business School, in Boston, Massachusetts – sequence: 2 givenname: Igal surname: Hendel fullname: Hendel, Igal organization: Igal Hendel is the Ida C. Cook Professor in the Economics Department, Northwestern University, in Evanston, Illinois – sequence: 3 givenname: Victoria surname: Marone fullname: Marone, Victoria organization: Victoria Marone is a PhD candidate in the Economics Department, Northwestern University – sequence: 4 givenname: Christopher surname: Ody fullname: Ody, Christopher organization: Christopher Ody is a research assistant professor in the Kellogg School of Management, Northwestern University |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/28874488$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1257/pol.20140335 10.1001/jama.2015.6807 10.1377/hlthaff.2014.1406 10.1257/aer.p20151081 10.1377/hlthaff.2016.0693 |
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| Copyright | Project HOPE—The People-to-People Health Foundation, Inc. Copyright The People to People Health Foundation, Inc., Project HOPE Sep 2017 |
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| References | B10 B11 B12 Jacob V (B7) 2015; 18 B14 B9 29642344 - J Urol. 2018 Apr;199(4):883-884 |
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| SubjectTerms | 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 |
| Title | Narrow Networks On The Health Insurance Marketplaces: Prevalence, Pricing, And The Cost Of Network Breadth |
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