by Katherine Restrepo
Director of Health Care Policy, John Locke Foundation
A new study released by Avalere Health reports that health insurance plans sold on the federal health law’s Exchanges come with narrower provider networks compared to commercial plans sold outside the Exchanges.
“Specifically, the analysis finds that exchange plan networks include 42 percent fewer oncology and cardiology specialists; 32 percent fewer mental health and primary care providers; and 24 percent fewer hospitals. Importantly, care provided by out-of-network providers does not count toward the out-of-pocket limits put in place by the ACA.“
Avalere’s methodology calculated the averages of five types of providers in exchange networks compared to commercial networks within the largest rating regions of the top five ACA enrollment states (North Carolina included).
Read the full report here.