California Healthline Daily Edition

Summaries of health policy coverage from major news organizations

Insurers Expand Health Exchange Plans’ Provider Networks

Insurers in several states are expanding their hospital and physician networks for plans sold through the Affordable Care Act's health insurance exchanges amid complaints from consumers and state officials about limited provider options, the Wall Street Journal reports.

For example, in California:

  • Anthem Blue Cross since Jan. 1 has added more than 3,800 health care providers to its network;
  • Blue Shield of California since April 2013 has increased the number of physicians in its exchange plan networks by 70% and the number of hospitals by 19%;
  • Health Net has increased its physician network by more than 68%; and
  • WellPoint has also substantially expanded its network.

Meanwhile, in New York, Fidelis Care has added more than 4,500 providers and 13 hospitals since Jan. 1. In addition, in Ohio, CareSource has added more than half-dozen new hospitals to its exchange network and intends to increase that number to more than 50.

According to the Journal, insurers have said that the network expansions are not in response to complaints from consumers and state officials, but instead reflect a growing willingness among providers to join the networks, which often pay less than employer-sponsored plans. David Thomas, COO of CareSource, said that more providers have joined "as we've started to get more enrollment and as we've shown that we are paying claims accurately and timely."

However, insurers also have said that limited provider networks help stem overall health care costs, indicating that while some insurers might expand certain network options, narrow networks still will be common in exchange plans. For example, a new study from McKinsey found that 48% of exchange plans have limited networks, including 69% of the least-costly exchange plans (Wilde Mathews, Wall Street Journal, 6/9).

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