Narrow Networks, Low Quality Not Linked in Covered Calif. Plans

Covered California health plans with narrow hospital networks typically do not trade quality of care for lower costs, according to a report by the California HealthCare Foundation, FierceHealthPayer reports.

CHCF publishes California Healthline (Finnegan, FierceHealthPayer, 10/14).

Details of Report

For the report, researchers used:

• Hospital quality data from the California Hospital Assessment and Reporting Task Force, which included 59 measures for 346 facilities; and
• Premium cost data from documents developed by Covered California for the second enrollment period (CHCF report, October 2015).

Findings

Overall, the report found that network size did not closely correlate with performance (FierceHealthPayer, 10/14).

However, the lowest-performing hospitals were in very small networks -- those with one to three facilities -- "suggesting that extreme narrowness may be problematic" (CHCF report, October 2015).

Instead, quality more significantly varied by region. For example, Covered California networks in San Francisco were higher-performing than those in Orange and Kern counties. According to the report, variations by region were likely the result of "more heavily concentrated, better resourced" facilities in Northern California, rather than network size (FierceHealthPayer, 10/14).

The report also found a "modest" relationship between premium costs and quality (Spurlock/Shannon, Health Affairs blog, 10/13).