Narrow network plans dominate ACA marketplace

Nearly three-fourths, or 72 percent, of health plans sold on the 2019 ACA marketplace have narrow physician networks, according to an Avalere study.

For its analysis, Avalere examined health plan information for policies sold on the federal ACA exchange from 2017-19. Researchers analyzed the prevalence of more restrictive plans, such as health maintenance and exclusive provider organizations, compared to preferred provider organizations and point of service plans with wider networks.

While the selection of insurance plans with tighter physician networks slowed during the 2019 plan year compared to the 2018 enrollment period, the ACA marketplace still is saturated with HMOs and EPOs, the researchers found.

"Provider networks are getting narrower, which means it is more important than ever that patients understand what kind of plans they are buying," Chris Sloan, director at Avalere, said in a news release. "Unknowingly enrolling in a narrow network plan could lead to patients being unable to see their preferred doctor or go to their most convenient hospital."

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