Will New Rules to Prevent Narrowing of Networks Drive Away Payers?

Healthcare providers have raised alarms over narrow provider networks in the public health insurance exchanges, but Moody’s Investors Service says proposed rules to open up the networks could drive health plans to drop out of the new market.

Proposed federal rules that would limit the ability of health plans to craft narrow provider networks for the Affordable Care Act exchanges would benefit some hospitals, but tighter regulation could create an unbearable level of risk for insurers, market analysts say. In a healthcare “sector comment” released recently, Moody’s Investors Service predicts that plans to limit narrow networks in 2015 would benefit rural hospitals and safety net hospitals because those facilities are the most likely to be left out of a narrow network.

“If [hospitals] are considered essential, that would protect them from being excluded from a narrow network,” Moody’s Senior Vice President Lisa Martin said Monday of the new rules under consideration at the federal Centers for Medicare & Medicaid Services. “[They provide] protection in terms of market share.”  Read the article in Health Leaders Media here

The Rural Voice ~ Advocating on behalf of the healthcare needs of rural Colorado, my blog posts feature rural health policy news.


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