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Network Adequacy: Balancing Cost, Access and Quality

Alliance for Health Policy

July 21, 2014
Recorded Online
District of Columbia

[Transcript and PowerPoint slides are online.]

Some new health plans sold in the insurance marketplaces are offering consumers networks that exclude certain doctors, hospitals and other medical providers. While some claim that these networks hamper provider access and choice, others contend that this approach, if done the right way, helps consumers by creating competition and controlling costs.

The Affordable Care Act made changes to the options insurers could use to balance risk, so some are being more selective in network composition.

A panel of experts will detail trends in composition of provider networks, explore cost, access, and quality tradeoffs, and examine recent regulatory and policy developments.

  • Colin Drozdowski, vice president of network development, WellPoint, will describe how WellPoint constructed its networks and the criteria it developed to determine inclusion.
  • Katherine Arbuckle, senior vice president and chief financial officer, Ascension Health, will discuss this providerís experiences across the country as it participates in some networks but not others.
  • Jolie Matthews, senior health and life policy counsel, National Association of Insurance Commissioners (NAIC), will talk about how insurance commissioners are examining and acting on this trend, and also model regulations that the NAIC is crafting.
  • Paul Ginsburg, Norman Topping Chair, Schaeffer Center for Health Policy and Economics, University of Southern California, will address implications of this trend.
Ed Howard of the Alliance will moderate.

Continue by clicking on the following link:

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