The limited participation of physicians, specialists and hospitals in health plans offered through the Patient Protection and Affordable Care Act individual insurance marketplace has undoubtedly been a sore spot for the landmark health law.
Consumers and even some providers have complained that the “narrow networks” offered by PPACA plans make it hard for many consumers, particularly those in rural areas, to find in-network medical services.
But whether it’s because insurers don’t want to offer broad networks or because doctors aren’t interested in taking PPACA health insurance isn’t always clear.
But a new study suggests that, while those with PPACA plans often have limited choices, the quality of the care they have access to is not bad, on average.
Specifically, a recent analysis by the Robert Wood Johnson Foundation found that of the 156 hospitals that landed in U.S. News and World Report’s annual “best hospital” list, more than 95 percent of them took at least one PPACA plan.
But, and there’s a big but, many of those same hospitals are accepting fewer PPACA plans than before. And the declines were particularly pronounced in metropolitan areas.
“The percent of hospitals in-network with only one marketplace plan increased from 7 percent in 2015 to 20 percent in 2016,” wrote Dr. Katherine Hempstead, the report’s author. “Customers loyal to a particular hospital can in most cases still find a marketplace plan that includes it, but choices are narrowed in 2016 relative to 2015; plans with these hospitals may be more expensive.”
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