Unbiased Analysis of Today's Healthcare Issues
Medicare Advantage (MA) plans have a number of advantages and drawbacks over traditional Medicare (TM) (i.e., fee-for-service). One advantage of MA plans is that cost sharing is often lower. Another benefit is that enrollees may receive additional coverage benefits. One drawback is that enrollee provider choice may be restricted. Fewer provider options may be bad…
Now that 51% of Medicare beneficiaries are enrolled in Medicare Advantage (MA), one key question is how restrictive are MA narrow networks? While beneficiaries enrolled in Medicare fee-for-service can choose any provider, MA plans can impose restrictions on enrollee’s provider choices. Measuring how restrictive an MA plan is, however, is difficult because “restrictiveness” is a…
As reported based on a N.Y. Times/KFF survey: A majority of Americans with health insurance said they had encountered obstacles to coverage, including denied medical care, higher bills and a dearth of doctors in their plans… About 40 percent of those surveyed said they had delayed or gone without care in the last year because…
According to a recent paper by Wallace (2023), the answer is ‘yes’, but it does so in a highly inefficient manner. Using 2008-2012 Medicaid data from the New York State Department of Health, the author find that: Leveraging the random assignment of over 50,000 Medicaid enrollees in New York, I present causal evidence that narrower…
Are narrow networks a good thing or a bad thing? The first thing you need to know is what is a “narrow network”. Narrow networks is an informal terms which basically means that your health plan either places restrictions over the providers you are able to see and/or you certain providers that are out of…
The premise is simple. Create markets, let consumers choose the products that fit them best, and the competition will lead to higher quality and lower prices. That is the premise behind the Affordable Care Act’s health insurance exchanges. A necessary condition for this to work, however, is that patients have visibility into the quality and…
Many health plans in the Obamacare health insurance exchanges aim to keep premiums down by limiting patients to a select group of providers (e.g., hospitals, physicians). The thought is, by limiting patients to a “narrow network” of providers, patients are in essence restricted to see the most efficient providers. Some may claim that “efficient” means high quality…
The Affordable Care Act aimed to increase patient access to care. Although it has certainly improved the share of patients who are insured, it is not clear whether it has actually improved “access.” Many health insurance exchange plans are able to offer low premiums by limiting the number or type of doctors you are able to…
One way for insurers to reduce health care costs is to restrict patient access to only lower cost providers. This phenomenon is known as narrow networks. On the one hand, narrow networks can promote efficiency by driving down provider price and directing patients to the highest value physicians. Alternatively, if insurers use narrow networks to direct patients…