New Hampshire Senators Scrutinize Anthem Blue Cross Narrow Network

Health insurer Anthem Blue Cross Blue Shield of New Hampshire fielded questions and criticism Wednesday concerning its new, narrower network that will exclude 10 of the state's acute-care hospitals, according to a Foster's Daily Democrat report.

Anthem President Lisa Guertin told state senators the insurer feels it has created a health insurance network that offers the best possible value and strikes a balance between accessibility and affordability, according to the report.

Anthem plans to shift the New Hampshire residents it covers under individual plans to the new network, including consumers who purchase coverage both inside and outside the health insurance exchange under the Patient Protection and Affordable Care Act. The network will include 74 percent of the state's primary care providers, 16 of its 26 acute-care hospitals and 85 percent of specialists, according to the report.

The insurer decided to shrink its network after determining it didn't need the state's 26 hospitals to serve and provide quality care to its enrollees. Anthem's goal is to reduce what preferred providers charge for care services.

Policymakers have previously expressed concerns about the network's accessibility. New Hampshire Senate Majority Leader Jeb Bradley told The Telegraph Anthem's plan will ration healthcare and will disrupt state residents' ability to get treated at the hospital or hospital-owned physician practice of their choice. New Hampshire Hospital Association President Steve Ahnen has also expressed concerns, saying his group questions whether the development will hinder patients' ability to get the right care at the right place and the right time.

Ms. Guertin told lawmakers and hospital leaders geography was the main reason behind the insurer's network provider selection decisions. When several senators complained that the network doesn't include any Sullivan County hospitals, she said the decisions were based on the distance consumers would have to travel to reach the hospitals rather than city or county borders, according to the Democrat. She said more than 90 percent of potential customers live within 20 miles of an in-network hospital.

Ms. Guertin also responded to questions about why Anthem didn't reach out to all state hospitals about participation in the network. She said doing so would have driven up health plan premiums, since in-network hospitals agreed to lower reimbursement rates in exchange for the promise of a certain patient volume, according to the report.

People who bought individual coverage through Anthem since Congress approved the PPACA in 2010 — about one-third of the current 40,000 people covered through individual plans — are exempt from the new policy, according to the report.

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