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Reform Update: Narrow Networks Bring Equal Parts Controversy and Savings
Health plans with narrow provider networks-which met with fierce backlash from patients and providers during the last go-around in the 1990s-are once again vulnerable to negative public opinion and legislative action.
Health plans with narrow provider networks—which met with fierce backlash from patients and providers during the last go-around in the 1990s—are once again vulnerable to negative public opinion and legislative action. But their failure now could undermine one of healthcare reform's key mechanisms for keeping premiums down, according to a special report from Moody's Investors Service.
The health insurance exchanges may suffer if plans and providers are required to broaden their networks in response to consumer backlash or new laws and regulations, Moody's Investors Service said in the report. “Narrow networks are one mechanism … that are being used by health care insurers to reduce healthcare costs,” said Moody's senior vice president Lisa Martin. Broader networks may include higher-cost hospitals such as academic medical centers which have added expenses for training future doctors. Premiums would rise to match the network's expenses, potentially driving away customers, Moody's said.
Marketplace success will depend on the degree that consumers trade off broad choice for cheaper prices and the strength of pushback from excluded providers.
Read the full story here: http://bit.ly/1nTjNfx
Source: Modern Healthcare
Sustaining Compassionate Trauma Care Across Communities
September 30th 2024September is National Recovery Month, and we are bringing you another limited-edition month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In our final episode, we speak with Lyndra Bills, MD, and Shari Hutchison, MS.
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Frameworks for Advancing Health Equity: Community Wellness Centers
September 27th 2024Delia Orosco, MS, director of Community Wellness Centers at Inland Empire Health Plan, shares insight into innovative initiatives provided by the wellness centers and their new mobile mammogram clinics.
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Accountable Care Organizations and HPV Vaccine Uptake: A Multilevel Analysis
October 24th 2024The authors evaluated whether adolescents receiving care at accountable care organizations (ACOs) vs non-ACOs were more likely to initiate and complete the human papillomavirus (HPV) vaccination series.
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Sarcoma Care: Biomarker Advancements Shape the Future
October 24th 2024At the regional Institute for Value-Based Medicine® event in Boston, Vinayak Venkataraman, MD, medical oncologist at Dana-Farber Cancer Institute and Harvard Medical School, was a panelist for the discussion, “Recent Advancements in Identifying Predictive Biomarkers for Sarcomas."
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