Narrow Networks on the Individual Marketplace in 2017

LDI Issue Brief. 2017 Sep;21(8):1-6.

Abstract

This Issue Brief describes the breadth of physician networks on the ACA marketplaces in 2017. We find that the overall rate of narrow networks is 21%, which is a decline since 2014 (31%) and 2016 (25%). Narrow networks are concentrated in plans sold on state-based marketplaces, at 42%, compared to 10% of plans on federally-facilitated marketplaces. Issuers that have traditionally offered Medicaid coverage have the highest prevalence of narrow network plans at 36%, with regional/local plans and provider-based plans close behind at 27% and 30%. We also find large differences in narrow networks by state and by plan type.

MeSH terms

  • Health Insurance Exchanges / statistics & numerical data*
  • Health Maintenance Organizations / statistics & numerical data
  • Health Services Accessibility
  • Humans
  • Insurance, Health / statistics & numerical data*
  • Medicaid
  • Patient Protection and Affordable Care Act / statistics & numerical data*
  • Physicians
  • Preferred Provider Organizations / statistics & numerical data
  • United States