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States won't likely boost oversight of narrow networks


Despite widespread public outcry regarding insurers' use of narrow networks, most states aren't likely to change their oversight of networks to require insurers to expand their covered providers, according to a new report from the Robert Wood Johnson Foundation.

Analyzing the networks available on health insurance exchanges in six states--Colorado, Maryland, New York, Oregon, Rhode Island and Virginia--researchers from the Georgetown University Health Policy Institute determined that there is a wide range of oversight regarding how many providers they must contract with.

Insurers and state officials in all six states said consumer concerns related to narrow networks centered around insurers' inaccurate provider directories and a lack of consumer-friendly, comparable information. Exchange enrollees also have been surprised when their doctors no longer take their insurance, FierceHealthPayer reported previously.

But officials said consumers rarely complained about not being able to obtain needed care from certain providers.

That's likely a large reason why few states seek increased oversight of narrow networks. Colorado regulators, for example, consider whether they should implement stricter network adequacy standards, noting that "we have to be careful, because if we [make] major changes, we could impact the market to an extent we don't want to."

In fact, researchers found that narrow networks will likely extend beyond individual plans to the group market as employers continue trying new methods to reduce their healthcare costs.

Many insurers already have added more doctors and hospitals to their exchange plan networks, saying the expansion reflects providers' increased willingness to join the networks.

To learn more:
- here's the RWJF report

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Narrow networks: Striking the right balance
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