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View Diary: New Mexico's ACA Plans Finally Published (5 comments)

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  •  How to value ACA Exchange Plans (0+ / 0-)

    How Narrow Networks affect Doctor Specialties is a study of WA exchange plans.  What is useful is the description of how you can find out availability of providers and possible out of network costs.

    Most coverage of ObamaCare (ACA) policies available through the Exchanges, especially Democratic-friendly coverage, has focused on the price of policies, rather than their value. This post focuses on value, and shows why the distinction between “in-network” and “out-of-network” coverage is important. At least in the case tested here, insurance companies are shown to “narrow” their networks, and hence the coverage available to their policyholders, to exclude specialties like oncology, cardiology, internal medicine, and
    neurology.  ...
    Bending the “cost curve” in this way appears to also bend “the care curve”
    As you can see from my results, the most under-represented specialties (on the left) are the ones that typically provide services to truly sick patients, such as oncology, cardiology, internal medicine, neurology. And no doctor specialty has more than about 75% representation on the Exchange provider networks. Hospitals are also included on the right of the graph. Their numbers are diminished in the Premera Exchange plan network via excluding specialty hospitals that are crucial to good care in this region, such as Children’s Hospital and the Seattle Cancer Care Alliance.
    This information is even more important than the premium costs.  You can be in the deep water when you need care if you are not diligent.

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