My latest post at the AcademyHealth blog:
Although the main thrust of the Affordable Care Act was to get more people health insurance, access is about more than just being uninsured. You still need to be able to see the doctors you need. One of the concerns expressed most often by consumers and experts alike involves the adequacy of networks in the plans offered in the exchanges.
Insurance companies can often reduce the cost of premiums by making deals with limited networks of physicians for reduced rates. By steering more patients into those networks, physicians can make up in volume what they might give up in per-patient reimbursement. Regulations mandate that all plans include “reasonable access” to “a sufficient number and type of providers”, but the devil is in the details. Research can inform us as to the adequacy of networks in exchange plans.