Obamacare Doctor Choices Narrow As Insurers Make More Money
Even though there are more health plan choices for consumers selecting Obamacare, insurers continue to limit physician choices via narrow networks.
The trend of health insurers narrowing medical provider networks to boost profits and more closely monitor doctor quality has escalated for insurers selling coverage under the Affordable Care Act for the 2019 health benefit year. This strategy comes even as health insurers jacked up premiums and made more money to fund expansion into new markets.
Nearly three-quarters, or 72% of health plans in the ACA’s exchange market have narrow networks , which restrict doctor and hospital choices to their lists of providers, Avalere Health, a health research and consulting firm, says in a new report. The 72% are generally health maintenance organizations (HMOs) or exclusive provider organizations (EPOs). Such narrow network plans have gradually become the dominant choice on the ACA’s exchanges, rising from 60% of the health plan choices just three years ago.
“Our research shows that plans are increasingly deploying narrow provider networks,” Avalere founder Dan Mendelson says. “This is a trend that we see elsewhere in health insurance markets, and is being deployed by plans to reduce cost and gain more control over patient outcomes.”
The narrow network trend comes with more health insurers participating in Obamacare. More than 600 counties have gained “at least one insurer in the marketplace while only five counties will lose an insurer” for 2019, the Kaiser Family Foundation said in a report last month.
Those signing up for 2019 coverage are finding far more health plan choices than two years ago when Aetna, Anthem, Humana and UnitedHealth Group scaled back or left the Obamacare business because they were unable to effectively manage the costs of sick patients signing up for coverage.