Missing the Boat on Narrow Networks
Sarah Kliff writes:
Did ObamaCare invent narrow networks? No, ObamaCare is accelerating a preexisting trend. Narrow network plans have become increasingly popular in recent years, growing from 15 percent of the insurance plans that employers offered in 2007 to 23 percent in 2012.
She then produces a chart from Kaiser showing the growth of “high-performance provider networks.”
Here is what she is missing. Note: narrow networks can be good or bad. Wall-Mart has selected half dozen centers of excellence around the country for its employees. These are places carefully chosen for their high quality and low costs. The exchange health plans, by contrast, appear to care only about cost. They are offering low fees sometimes even lower than what Medicaid pays — and accepting only those providers who will take whatever fee is offered.
John is spot on
Good things can come in small packages
At National Prosperity Life and Health we will ultimately be looking for the finest providers for excellent reimbursements. The exact opposite of what people think of with small networks
Of course to be ACA compliant the networks must adequately serve our clients
We should be applying to the TX Dept of Insurance for our license next week and look for a March approval
Agents who have self funded employers with 200 or more employees are welcome to get in line
Don Levit
CFO of NLPH
Tpabenefit.com
There may be a trend to ever-narrower networks. But there’s another trend–a trend toward Travel Medicine, where the network is as broad as the whole world!
In many foreign places, like Thailand and India, health care generally costs 1/10, in Mexico 1/3 and in Brazil and Costa Rica 1/2 of what you’d pay in the USSA.
Of course, to realize the gains from Travel Medicine, it’s best not to squander your funds on Obamacare.
It is actually becoming an industry of its own. Travel Medicine is a big deal. Several countries where healthcare is relatively cheap, are modernizing their infrastructure to handle foreigners who travel solely for health purposes. The new legislation in the US will end up hurting US health professionals.
Vacations for everyone
Depending on the country you could live there post surgery for a while.
Medical Tourism YES! I can’t wait for some Amerikan docs to get together to open clinics just over the Mexican and Canadian borders–kind of like a maquiladora–that would serve only Amerikans.
They could escape all the Obamacare regulations as well as USSA drug pricing, reporting requirements, prescription drug rules, etc. They could even offer insurance just to Amerikans who were interested.
I think that one of the most important things when we think about healthcare is quality. I would prefer paying more for a service that offers a better quality than having a cheap service that is going to let me die when I’m sick.
That’s the argument for more expensive healthcare.
Well of course they want you to pay more. Who doesn’t want “quality”
And how, pray tell, do you figure out the quality, seeing that all quality and pricing information is well hidden by the insurance-medical-drug complex?
Plans can either be broad or narrow, its how the outcome can affect whether they are delivering quality coverage at a reasonable cost to their customers.
What can be defined as reasonable though?
Two quick comments:
1. If insurers on the exchanges are offering such low fees, then why are their premiums so high for the coverage offered?
The answer probably has a lot to do with guaranteed issue. Still, one wonders when the poor policyholder will get a break.
2. There are numerous insurance plans in MN that exclude Mayo Clinic because of Mayo’s high costs.
Walmart never pays top dollar, so I wonder if we are getting the whole story about their choices of centers of excellence.
Agreed, Walmart never pays top dollar. Yet, they are a big corporation with thousands of employees. They have leverage when dealing with the insurance companies. One possibility is that they were able to get a cheap deal, with a high quality provider. Also, excellence is relative. An excellent coverage under Walmart standards might be different from your standards.
I read that ALL the first-class cancer treatment centers, including Cedars-Sinai, MD Anderson and the Mayo Clinic, are excluded from Obamacare coverage.
“These are places carefully chosen for their high quality and low costs.”
Narrow networks could potentially work if these were the guidelines that ObamaCare followed. Given the fall out with small business, we’ve seen they are unable to make the networks work as of yet.
Having a narrow network is fine when it serves your needs, its when it bars you from a preferred provider that things begin to break down.
That is the true problem with ObamaCare is that it is unable to meet the needs of the consumer. Coupled with rising costs and this is how the narrow network is unable to work.
Thanks for the post John!
According to the Wash Post, 11-20-13, health plans are saving up to 25% of costs by excluding the most expensive academic hospitals.
that is a lot!
I suspect this is because even one or two premature infants or cancer patients can throw a health plan into loss territory.