Complaints about health insurers’ ‘narrow networks’ are misleading

Premium increases for Georgia’s insurance exchange health plans beat regional and national rates, according to a recent study by the Urban Institute, cited by Georgia Health News.

Graham Thompson

This is good news, as many Georgians shopping on the exchange will see only a modest increase from 2014 options, and some rural parts of our state will experience a significant decrease.

What is driving this good news?

The study’s conclusion cites increased plan competition and “high-value” medical provider networks — used by health plans to reduce costs and provide incentives for high-quality and cost-effective care — as holding down premiums.

It should be noted that all Georgia Association of Health Plans (GAHP) members offer plans on the exchange, with three member plans offering options statewide, continuing our commitment to serve all Georgians. It should also be noted that high-value networks are working as an option for cost-conscious consumers.

Detractors often label high-value provider networks as “narrow networks.” Although there is no recognized definition of this term, lobbyists for high-cost doctors use it to portray some plans as insufficient.

The word we really should be focusing on is not “narrow,” but “affordable.” Consumers demand affordable options with access to doctors and hospitals with the best track record of delivering high-quality, cost-efficient care.

These plans are real, robust insurance products, as current federal and state laws ensure consumers have access to an array of physicians and hospitals and require coverage of “Essential Health Benefits.”

GAHP plan members are committed to providing timely, accurate information about doctors participating in all plans, utilizing websites and 800 numbers aimed at enhancing customer education.

Given the challenges of provider consolidation and health insurance taxes, health plans need the flexibility to offer high-value products as an option for Georgians to continue to hold down higher health plan premium increases.

If Georgians want a plan with a broader group of providers, they can pick such a plan. Those options are definitely available.

But if consumers are not picking plans with more providers — and most consumers are not — it’s simply because they favor high value over high cost.

Graham Thompson is executive director of the Georgia Association of Health Plans.