Narrow Networks May Soon be Regulated

Moving toward narrower networks is a growing trend that was ultimately accelerated with the birth of Obamacare. Limiting the physicians that were available to their customers has been used as a way to control costs. Plan subscribers would still have access to a physician of their choice that is not in their network, but it would be more costly for the patient rather than the insurance company.

There has been a growing concern that the reduction of physician networks have resulted in a very limited selection, especially when it comes to certain specialties. According to an article published on Fierce Health Payer, a study reported that up to 14 percent of health plans in the federal marketplace did not have a physician in-network for at least one common specialty.

Similar findings have resulted in the National Association of Insurance Commissioners (NAIC) proposing new regulations on insurance plans’ physician networks. Creating a set of standards would potentially eliminate customers from having to go out-of-network and pay costly fees associated due to restricted network options.

The goal of ACA was to provide quality care to patients and the NAIC’s regulation proposal is ensuring that customers’ access to physicians are not being restricted.

The NAIC insists that there would be a multitude of factors considered when reviewing a plan’s network of physicians. Analyzing everything from physicians’ average weight times to their medical delivery methods would all be reviewed.

When it comes to narrow physician networks, what are your thoughts? Should the networks be subject to regulations or is it up to the insurance plans to set their in-network providers?

To read more about the NAIC’s proposed regulations, click  here.

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