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  • Health Affairs

Narrow Networks on the Health Insurance Marketplaces: Prevalence, Pricing, and the Cost of Network Breadth

By: Leemore S. Dafny, Igal Hendel, Victoria Marone and Christopher Ody
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Abstract

Anecdotal reports and systematic research highlight the prevalence of narrow-network plans on the Affordable Care Act’s health insurance Marketplaces. At the same time, Marketplace premiums in the period 2014–2016 were much lower than projected by the Congressional Budget Office in 2009. Using detailed data on the breadth of both hospital and physician networks, we studied the prevalence of narrow networks and quantified the association between network breadth and premiums. Controlling for many potentially confounding factors, we found that a plan with narrow physician and hospital networks was 16% cheaper than a plan with broad networks for both, and that narrowing the breadth of just one type of network was associated with a 6%–9% decrease in premiums. Narrow-network plans also have a sizable impact on federal outlays, as they depress the premium of the second-lowest-price silver plan, to which subsidy amounts are linked. Holding all else constant, we estimate that federal subsidies would have been 10.8% higher in 2014 had Marketplaces required all plans to offer broad provider networks. Narrow networks are a promising source of potential savings for other segments of the commercial insurance market.

Keywords

Health Care and Treatment; Insurance; Cost; United States

Citation

Dafny, Leemore S., Igal Hendel, Victoria Marone, and Christopher Ody. "Narrow Networks on the Health Insurance Marketplaces: Prevalence, Pricing, and the Cost of Network Breadth." Health Affairs 36, no. 9 (September 2017).
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About The Author

Leemore S. Dafny

General Management
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  • Two Approaches to Capping Health Care Prices By: Michael E. Chernew, Maximilian J. Pany and Leemore S. Dafny
  • How Do Copayment Coupons Affect Branded Drug Prices and Quantities Purchased? By: Leemore S. Dafny, Kate Ho and Edward Kong
  • Regulating Hospital Prices Based on Market Concentration Is Likely to Leave High-Price Hospitals Unaffected By: Maximilian J. Pany, Michael E. Chernew and Leemore S. Dafny
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