Study Finds ACA Plans Have a Third Fewer Providers than Employer-Based Plans

Monday, July 20, 2015
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law


A new study found that consumers who bought insurance on health exchanges last year had access to one-third fewer doctors and hospitals than people with traditional employer-provided insurance.

Consulting firm Avalere Health conducted a study that provides a statistical basis which supports anecdotal reports from consumers and others. The study revealed more limited doctor and hospital choices in plans offered on marketplaces created by the Affordable Care Act (ACA).


Narrow Networks Negotiate Contracts with a Select Number of Providers.

Health plans in narrow networks negotiate contracts with just a select number of providers who agree to be reimbursed at lower rates. Insurers can set their premiums lower; however, depending on the plan’s design, consumers typically pay more. Sometimes it can be much more if the doctor is out of their network’s coverage.


The Numbers are Low Compared to Other Health Care Networks.

Exchange plans had networks with 42 percent fewer cancer and cardiac specialists. They have 32 percent fewer mental health providers and 24 percent fewer hospitals.


Comments?


Do you think it’s fair that people with ACA receive fewer providers? Do you have ACA? Please leave any thoughtful comments below.


Contact Experienced Health Law Attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.


Sources:

Sun, Lena H. “Report: ACA plans have a third fewer providers than employer-based plans.” (July 15, 2015). From: http://www.washingtonpost.com/national/health-science/report-aca-plans-have-a-third-fewer-providers-than-employer-based-plans/2015/07/15/6ee8ebf2-2b08-11e5-a250-42bd812efc09_story.html


About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.


KeyWords: Affordable Care Act, ACA, insurance, insurance coverage, Florida attorney, health care lawyer, health care attorney, law, health law, health care law, Obamacare, physician attorney, health care defense attorney, health care defense lawyer, health care, health care coverage, Avalere Health, The Health Law Firm reviews




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7/20/2015

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