Скачать или смотреть October 2015: "Narrow Networks: Do We Know When Networks Have Become Too Narrow?"

http://healthpolicy.ucla.edu

The Affordable Care Act (ACA) has created a greater degree of standardization of health insurance plans than has ever existed in the individual (non-group) health insurance market. All policies are required to have Essential Health Benefits, as well as four metal tiers based on plan actuarial values and standard limits on maximum annual out-of-pocket spending. As a result, one of the most significant remaining features of health plans that can vary considerably is the number of doctors and hospitals contracting with each health plan. The fact that many health insurers offered plans through ACA Exchanges in 2014 and 2015 with so-called “narrow networks” has led to some concern that those buying health insurance in the individual market, both inside and outside the Exchanges, now face more restricted access to doctors and hospitals in their immediate geographic area. Furthermore, this restricted access has raised concerns about possible adverse health consequences.

This October 28 webinar presents an overview of the impacts of “narrow networks.” In it, Gerald Kominski, the Center’s director, summarizes what is known about narrow networks from the research literature; discusses challenges in defining and measuring network adequacy; and proposes further research to determine whether narrow networks are necessarily associated with lower quality care.