CMS Pilot Program to Compare Network Breadth of Health Plans

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In April of 2016, CMS announced that a new type of tool to help consumers compare the breadth of plans’ networks on HealthCare.gov. A recent update to that announcement (September 2016) has notified the public that the roll out should start in 2017, for a small number of states.

Right now, consumers searching for a health plan search for certain doctors or hospitals, to make sure those in their area are covered by the plan. Right now, there is no way to actually view the narrowness of a plan’s network.

The network breadth ratings with data submitted to CMS as part of the qualified health plan (QHP) application. “Network breadth information will display to consumers shopping for plans in the individual market only in the pilot states.” CMS hopes to consider expanding the pilot program to additional states in later years, but first will take detailed data and reviews from the current pilot program.

Plan for 2017

According to CMS, “network breadth information will display for the selected pilot states: Maine, Ohio, Tennessee, and Texas. During open enrollment, consumers in these pilot states will see information classifying the relative breadth of the plans’ provider networks, as compared to other Marketplace plans in the county.”

Consumer will then be able to compare network breadth for three types of providers:

  • adult primary care providers
  • Pediatricians
  • Hospitals

Full press release here.

2017-04-02T13:28:00+00:00 By |Health Insurance, Uncategorized|

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