Researchers from Philadelphia-based University of Pennslyvania, led by Laura Yasaitis, PhD, postdoctoral researcher of health policy at the university’s Perelman School of Medicine, analyzed provider networks on the individual health insurance exchanges for the 2014 plan year. Study authors examined oncologist supply and network participation in areas with and without one of 69 National Cancer Institute-designated cancer centers, which are recognized for high-quality cancer care. Researchers then evaluated how often physicians affiliated with NCI-designated centers were covered by narrow-network plans.
The study found oncologists affiliated with NCI-designated facilities were twice as likely to be excluded from health plans with the most narrow networks.
“This finding suggests that narrow provider networks may not just have fewer providers from which to choose; in addition, the more limited list of available providers may not offer the same quality care as those providers who have been excluded from the network,” the authors said. “This highlights a critical tradeoff consumers face when purchasing a narrow network plan.”
The authors added health insurers, state regulators and federal lawmakers should help consumers learn about cancer care providers’ relationships with narrow-network plans.
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