There’s been a lot of talk about “narrow” networks in ACA plans, which trade off limited provider coverage for lower premiums. Using a new integrated dataset of physician networks in plans on the federal and state marketplaces, our latest LDI/RWJF Data Brief describes the breadth of physician networks across all silver plans sold in 2014. Using consumer-friendly “t-shirt” sizing, we find that more than 40% of networks can be considered small or x-small, including 55% of networks in HMOs and 25% of PPO networks.
That’s the first paragraph of Janet Weiner’s post, which describes the findings in greater detail, including some nice charts. I don’t want to steal her thunder, or that of her co-author (Dan Polsky) and sponsors. So, click through and read.
Let me just go a bit meta: If you’re not a researcher, you may be among those that think work like this is fairly straight forward. “What? You just grab the data, do some manipulations in Excel, make some charts. Boom! A data brief.”
Well, no. The problem is, data like these don’t exist in research-ready datasets. The investigators had to painstakingly scrape them from hundreds of web pages and documents, all in different formats, requiring different approaches. I know from talking to Dan that it was an enormous undertaking.
And now you should be annoyed. Here’s what you should be thinking: “Why on earth is it so hard for researchers, let alone consumers, to obtain network information? Shouldn’t this be readily available and easily comparable across plans? How are people to meaningfully shop on exchanges without it?” You should be enraged about this!
Ah, now you’re with me, and us. This work was not only hard, but incredibly important. It’s a bit weedy to those of us who are NOT shopping for exchange coverage and, perhaps, NOT worked up about policy nuances pertaining to doing so. But if you can put yourself in the mind of someone who is one of these things, you can see what a big deal this is.
With that, go read the rest.