California has the nation's fourth-highest rate of so-called narrow health plans through the Affordable Care Act, a new study says. Californians with those plans have access to 25 percent or less of the doctors and physicians in their rating area, the study says.
About 75 percent of the health plans available in California through the Affordable Care Act, commonly known as Obamacare, are narrow plans, placing California behind just three other states: Georgia, Florida and Oklahoma, the Los Angeles Times reported. About 41 percent of plans nationwide qualify as narrow plans, and 12 states have no narrow network plans, the study says.
Insurance providers created the narrow plans in order to keep healthcare costs down. The plans limit the number of physicians from whom individuals with the less-expensive plans can seek care. The problem, however, is that when signing up for a plan, it isn't always clear which plans are narrow and which plans aren't.
"We need a good way to communicate this information to consumers so they can make an informed decision at the point of purchase for a health plan," said Dan Polsky, executive director of the Leonard Davis Institute of Health Economics at the University of Pennsylvania, which conducted the narrow plan study. "Narrow networks in my opinion aren’t necessarily bad things, but they are being poorly implemented."
The reason why some states have narrow healthcare plans while others don't was unknown, the study's researchers wrote. There was, however, a strong correlation between states with more HMO plans and states with more narrow care plans, according to FierceHealthPayer.com.
Planned regulations are expected to require that healthcare providers create directories that are more transparent so consumers can know ahead of time if they are buying into a narrow network before enrolling.
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