Network focus could shift to branding, quality

Increased competition in the HIX marketplace is expected to pave the way for branded health options with strategic tiers or regional provider partnerships that offer a leg up on narrow networks, especially with 25 million Americans projected to sign up for exchange plans over the coming decade.

One such example involves New Hampshire, where choice is deepened with the entrance of four new insurers offering plans both on and off the exchange. Granite State residents had just a single HIX selection during the past year.

Also see: How to make the most of narrow networks

Another noteworthy development is that providers could strike deals with insurers or even establish their own HIX plans as narrow network marketing strategies shift, according to Healthcare Payer News.

The article quoted a senior product manager with the nation’s second-largest provider-owned plan who suggested at a recent conference that the focus must now shift to high-quality networks as the market evolves. Adam Pittler of the UPMC Health Plan, which began selling exchange policies last year, predicted that premium prices will “converge” with other key factors. Examples included cost-sharing, drug formularies, access to prestigious institutions and non-essential health benefits such as gym discounts or telemedicine.

But for now, many HIX enrollees appear to favor lower-cost options over broader networks – even with the availability of subsidies and especially if they’re healthy. CoOportunity Health CEO and president Cliff Gold reported to Healthcare Payer News that 41% of new members in Iowa chose narrow network plans compared with 38% opting for middle-network plans and just 21% choosing broad networks. His nonprofit consumer-operated and oriented plan sells options in Iowa and Nebraska both on and off the exchanges.

“Consumers have many choices when it comes to networks, and health plans are focused on making sure individuals and families have the resources and support they need to pick the coverage option that works best for them,” says Clare Krusing, a spokeswoman for America’s Health Insurance Plans.

Shutan is a Los Angeles-based freelance writer.

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