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Narrow Provider Networks Growth Accelerates

November 10, 2015 | Leave a Comment

Narrow insurance networks are gaining traction across the United States, as insurers have limited options for offering plans at different price points.  The growth comes as mandated changes in the Affordable Care Act have spurred this growth in the individual markets and now are gaining market share in the employer sponsored group market.

Insurers can use narrow networks to lower premiums by excluding high-cost providers or by offering a fixed reimbursement level to all providers.  These savings can provide some premium relief to those price conscious consumers.  However many factors must be analyzed before making this decision.   Consumers may find that their regular providers are no longer considered in-network after selecting their plan for the coming year.   This can be devastating to those with complex medical conditions as they may have limited access to adequate facilities and specialty physicians.

When selecting a health plan is it vital that the provider network be evaluated to avoid the potential downside of these narrow networks.  Transparency and regulation are needed in the future to ensure sufficient network adequacy in the future.  To read more on this topic click here.

Rodney Ragsdale, Vice-President at the Cornerstone Insurance Group

Posted in Benefits

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