Network Adequacy: Balancing Cost, Access and Quality

July 21, 2014

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 detailed trends in composition of provider networks, explore cost, access, and quality tradeoffs, and examine recent regulatory and policy developments.

Daniel Durham, executive vice president for policy and regulatory affairs, America’s Health Insurance Plans (AHIP).

Katherine Arbuckle, senior vice president and chief financial officer, Ascension Health, discussed this provider’s experiences across the country as it participates in some networks but not others.

Brian Webb, manager of health policy and legislation, National Association of Insurance Commissioners (NAIC), talked 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, addressed implications of this trend.

Ed Howard of the Alliance moderated.

Follow the briefing on Twitter: #NetworkAdequacy

Contact: Marilyn Serafini (202)789-2300

The event is sponsored by the nonpartisan Alliance for Health Reform and WellPoint.


Full Transcript (Adobe Acrobat PDF)

Speaker Presentations

Paul Ginsburg Presentation (Adobe Acrobat PDF)
Daniel Durham Presentation (Adobe Acrobat PDF)
Katherine Arbuckle Presentation (Adobe Acrobat PDF)
Brian Webb Presentation (Adobe Acrobat PDF)

Event Details

Agenda (Adobe Acrobat PDF)
Speaker Biographies (Adobe Acrobat PDF)

Event Resources