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Narrow Networks on the Individual Marketplace in 2017.

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Physician network breadth on ACA marketplaces declined in 2017, with narrow networks affecting 21% of plans. These limited networks were more common in state-based marketplaces and plans from traditional Medicaid issuers.

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Area of Science:

  • Health Policy
  • Health Insurance Markets
  • Network Analysis

Background:

  • The Affordable Care Act (ACA) marketplaces offer various health insurance plans.
  • Physician network breadth is a key feature influencing plan choice and access to care.
  • Understanding narrow networks is crucial for evaluating marketplace competition and consumer protection.

Purpose of the Study:

  • To describe the prevalence and characteristics of physician networks on ACA marketplaces in 2017.
  • To analyze trends in narrow network usage since 2014.
  • To identify factors associated with the concentration of narrow networks.

Main Methods:

  • Analysis of plan data from the 2017 ACA marketplaces.
  • Categorization of networks based on provider accessibility.
  • Comparison of narrow network rates across different marketplace types and issuer characteristics.

Main Results:

  • The overall rate of narrow networks was 21% in 2017, a decrease from 31% in 2014 and 25% in 2016.
  • Narrow networks were more prevalent in state-based marketplaces (42%) compared to federally-facilitated ones (10%).
  • Issuers with prior Medicaid experience (36%), regional/local plans (27%), and provider-based plans (30%) showed higher rates of narrow networks.

Conclusions:

  • Physician network breadth on ACA marketplaces has generally increased, indicating a potential improvement in provider access.
  • Marketplace structure and issuer background significantly influence the prevalence of narrow networks.
  • Further research is needed to understand the implications of narrow networks for healthcare access and quality.