Insurers bolster narrow networks


Many insurers are adding more doctors and hospitals for plans sold on health insurance exchanges. But they insist the provider expansion isn't a result of public outrage and pushback against narrow networks; instead it reflects providers' increased willingness to join the networks.

Blue Shield of California, for example, has increased the number of hospitals in its exchange plans by 19 percent and doctors by 70 percent since it originally filed plan designs last year. This growth is a "strategic buildout" of an already strong network, Ken Wood, a senior vice president for Blue Shield, told the Wall Street Journal.

Although Blue Shield's exchange plans now include 254 hospitals and more than 36,000 physicians, the networks are still smaller than its off-exchange coverage.

Anthem Blue Cross, also in California, has added almost 4,000 providers, including major hospitals like UC Davis Medical Center and Cedars Sinai Medical Center, to its network this year, FierceHealthPayer previously reported.

Meanwhile, in Ohio, CareSource has expanded its network to include more than six hospitals as it works toward having more than 50 hospitals in its network. Fidelis Care, a primarily Medicaid insurer in New York, has added more than 4,500 providers, including 13 hospitals, this year. More hospitals and doctors have joined "as we've started to get more enrollment, and as we've shown that we are paying claims accurately and timely," David Thomas, chief operating officer for Fidelis Care, told the WSJ.

But these insurers say the reason behind the expanded networks isn't related to public complaints or new state requirements for wider networks like the one recently enacted in Washington. Rather, the widening of networks simply shows doctors and hospitals are more willing to join the new exchange networks. Plus, insurers are making adjustments based on the specific members who have enrolled. For example, CareSource said it added a children's hospital in Cincinnati to its network because many of its new members have children.

To learn more:
- read the Wall Street Journal article

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