Narrow networks aren’t new and will continue to resurface as pressure remains steady to maintain existing quality levels while keeping cost down under the Affordable Care Act. With price as a customer focal point, almost all insurers made network design changes for 2015, varying by state, improving or expanding narrow networks.
States took different and typically multiple approaches for network designs. For example in Colorado one health insurer offered broad networks but also offered a narrow network in Denver only. Strategies in New York ranged from cutting network providers compared to their off-marketplace plans to semi-exclusive alignment with certain hospital systems. Maryland’s marketplace officials encouraged insurers to narrow networks to push down costs however Maryland insurers made no changes to their networks, which continue to be broad. In Oregon, one insurer held 76 percent of enrollees. How did they do that, quality? Education? Not likely, it’s more likely that low pricing was a primary consumer driver and networks are narrowed to easy pricing.
Insurers are experimenting in the first few years. They are conducing user forums and surveys to better understand what drives a customer to select a health plan. The more surveys that are conducted the more the results are the same; price is the primary decision point.
The challenge is the desire to provide choice for consumers while containing costs, may directly conflict. The good news is competition and choice are increasing in 2015.