Health Plan Provider Network Size, Composition, and Premiums

Tuesday, June 14, 2016: 10:15 AM-11:45 AM
B21 (Stiteler Hall)
Jean Abraham

Health plans can vary on several dimensions, including which services are covered, cost-sharing provisions such as deductibles and coinsurance, and the network of providers through which enrollees can obtain medical care. In 2014, insurers began offering individual health plans through newly created Exchanges. With increasing regulatory requirements on covered services and cost-sharing introduced by the ACA, many insurers are adopting the strategy of limiting provider networks in an effort to keep premiums low. Policymakers have expressed concerns that some insurers’ networks are “too narrow” and that beneficiaries could face serious access and choice problems as a result. At present, there is very limited empirical research investigating the relationship between premiums and provider network size or composition. This session includes three papers that investigate the issue of Exchange-based health plan provider networks and their relationship with premiums.

10:15 AM
Insurance Pricing and Narrow Networks on the Federally Facilitated Marketplace

Author(s): Jeffrey S. McCullough; Jean Abraham; Coleman Drake; Kosali Simon

Discussant: Aditi Sen

10:35 AM
Narrow Networks on the Health Insurance Marketplaces: What Hospitals are In or Out and How Does it Affect Premiums and Consumer Choices?

Author(s): Leemore Dafny; Christopher Ody; Nathan E. Wilson; Igal Hendel

Discussant: Roger Feldman

10:55 AM
Provider Network Size and Marketplace Plan Premiums

Author(s): Daniel Polsky; Zuleyha Cidav

Discussant: Keith Ericson