Provider networks exclude some top cancer centers


The Affordable Care Act prohibits insurers from denying cancer patients coverage or charging them much higher rates and guarantees free cancer screenings. However, coverage expansion provisions don't include guaranteed access to specialty cancer hospitals.

Provider networks on insurance exchanges exclude some of the nation's best cancer hospitals, which concerns some state insurance regulators and patient advocates, the Associated Press reported.

The Obama administration says cancer care will take priority next year when it closely scrutinizes the 36 federally-run exchanges.

AP surveyed 23 nationally recognized comprehensive cancer centers and found only four of 19 respondents said all insurers in their state's exchange included them as a network provider.

Narrow networks of hospitals and doctors allow insurers to offer health plans with more efficient providers, thereby cutting costs while also improving care. With that in mind, most private plans on the exchanges limit providers, including cancer centers, available in-network. In fact, a December 2013 study found roughly 70 percent of hospital provider networks on the exchanges are either narrow or ultra-narrow.

Although cancer patient advocates worry about limited treatment options, they acknowledge the coverage improvements already in place. 

"Patients may have fewer choices of doctors and hospitals in some exchange plans than others ... but the rules for such plans go a long way toward remedying the most severe problems that existed for decades," Steve Weiss, spokesman for the American Cancer Society Cancer Action Network, told the AP.

For more:
- here's the AP article

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