Health Plan Provider Network Size, Composition, and Premiums
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.