Doctor networks shrinking under ObamaCare, study finds

The number of doctors available in many healthcare plans is shrinking under ObamaCare, forcing some patients to pay more or switch providers, according to a new report.

Four in 10 healthcare plans sold through the government’s marketplace have so few options that their networks are described as “small” or “extra small,” according to a report by the Robert Wood Johnson Foundation.

A small network means that plans cover fewer than 25 percent of doctors in the area, while extra small covers fewer than 10 percent, according to the group’s definition.  

{mosads}The report — the first to include data on individual physicians, rather than hospitals — looked at 395 provider networks offered by 268 different insurers.

While not a new concept, health insurance companies are increasingly turning to “narrow networks” as a way of containing costs under ObamaCare.

This can leave patients “vulnerable to the financial burden of out-of-network care,” the authors warn.

Under the Affordable Care Act, each network must be “sufficient in number and types of providers,” though many healthcare experts have complained that the definitions are unclear.

Most states have different rules related to access, ranging from driving distance to providers and appointment availability.  

Reducing the size of a network is “one of the only remaining pieces in the insurers’ cost-containment toolbox,” the report writes.

Smaller networks are typically cheaper for insurance companies because they can keep patients from visiting high-cost providers. Insurers can also negotiate lower rates if they can offer doctors and hospitals a greater number of customers. 

Tags Health insurance in the United States Healthcare reform in the United States Patient Protection and Affordable Care Act
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