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Posted by on Oct 11, 2013 in Uncategorized | 0 comments

Narrow network trend on the rise

Narrow networks aren’t just being used for exchange products

The launch of public health insurance exchanges under the Affordable Care Act has meant the introduction of plans with limited provider networks. These narrow network plans offer lower premiums in exchange for limited provider access, a trade-off insurers believe many price-sensitive Americans will be willing to make.

It now appears that the rise of narrow network plans is not limited to the ACA’s public health insurance marketplace. In Connecticut, UnitedHealthcare is dropping doctors from its Medicare Advantage plans next year. According to Matthew Sturdevant, UnitedHealthcare spokesman Benjamin Goldstein confirmed that the insurer was making cuts to its provider network in an email, stating that “With the many changes happening in health care, we are building a network of health care providers that we can collaborate with more closely to have the most positive impact on the quality of care for our members. This will encourage better health outcomes and ultimately lower costs.”

According to Richard lee of the Stamford Advocate, “UnitedHealthcare sent a letter dated Oct. 2 to 810 primary care physicians and 1,440 physician specialists, telling them that the separation from its Medicare Advantage network would be effective Feb. 1, 2014.” The Fairfield County Medical Association’s Mark Thompson said the association estimated that the 2,250 represents about 19 percent of the insurer’s physician network in Connecticut.

The launch of public health insurance exchanges is just the beginning of the transformation of the U.S. healthcare system. The use of narrow networks in health plans is a change that can be expected to continue to spread to lines of business outside of the exchanges.

Jillian Carlile
Research Analyst & Health Exchange know-it-all
Strenuus
jcarlile@strenuus.com

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Strenuus® is the industry leader in delivering network competitive intelligence services. We are the largest collector of managed care data in the country. With a singular focus on the managed care industry, we provide services to support payors, brokers, consultants and healthcare IT companies. Whether you represent employer-based coverage, Medicare, Medicaid, dental, work comp or specialty networks, we have the data and insights you need.

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  1. Blues plans take early lead in exchange market | Strenuus Insights - […] limited or narrow networks are being implemented by multiple insurance carriers both on and off the exchanges as a strategy to control costs…

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