Health plan features: implications of narrow networks and the trade-off between price and choice
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Research insights
- Author(s):
- Summer, Laura, author
- Contributor(s):
- AcademyHealth, issuing body.
- Publication:
- [Washington, D.C.] : AcademyHealth, December 10, 2014
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Choice Behavior Gatekeeping Health Care Costs Health Manpower Health Plan Implementation Health Services Accessibility Consumer Advocacy Cost Control Insurance, Health Humans United States United States.
- Genre(s):
- Technical Report
- Abstract:
- The use of narrow provider networks in health insurance plans is a cost containment strategy that has gained popularity of late. Network design features differ among plans, but insurers generally seek to offer lower premiums by limiting the group of providers available to plan enrollees. As interest in the use of narrow networks has increased, so have concerns about their effect on consumers' choices, costs, and access to care. With the growth of narrow network plans, it is important to understand the effectiveness of existing and emerging network design strategies and the potential for policies to ensure consumer access to high-quality care. This brief summarizes key points from an expert panel AcademyHealth convened in December 2014 to examine existing research on network design and use, to discuss the impact of narrow networks and tiered networks on consumers, to review policies and practices for ensuring that networks are adequate, and to identify areas for additional research. Research on the impact of narrow networks is limited, but early studies suggest that several factors affect whether narrow network strategies will succeed. These factors include the way networks are constructed, the characteristics of the broader market in which narrow network plans operate, and whether consumers have the knowledge and tools to make informed choices about coverage. Additional research is needed to help policymakers better understand how to define and develop enforceable standards to measure the adequacy of narrow networks. Research can also help identify the quality considerations to be incorporated into the network design process, the development of network adequacy standards, and the type of guidance that can help consumers understand plan differences when making choices among products.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (9 pages)).
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101656841 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101656841