Robert Book: Narrow Networks Do Not Lead To Care Coordination

When the ACA networks began covering patients in 2014, one of the first complaints was that many plans were trying to cut costs by including many fewer providers in their networks than pre-ACA health plans. In some cases, patients even had to cancel previously scheduled surgeries and lost access to prescription drugs, since the surgeons and/or the hospitals were not in their new networks. Now, a study by the health consulting firm Avalere confirms that these were not isolated cases – on average, exchange plans include a 34 percent fewer in-network providers than non-exchange plans (such as employer-sponsored plans), with even larger shortcomings in specialties like oncology and cardiology.