Most patients, myself included, do not like to be told, “You can’t see that doctor or go to that hospital.” But the message is becoming more common as we, patients, or our employers choose what are known as “limited” or “narrow” network plans (note the not-so-subtle name change).
These plans are often cheaper than other options because they cut out expensive hospitals and because insurers negotiate better prices with hospitals and doctors who are promised our business.
It looks at a broad movement toward limited network plans in Massachusetts in 2011, when state employees got a three-month “premium holiday” if they switched from more traditional coverage to the lower-cost option.
State employees who chose to switch reduced their health care spending by 36 percent.
“Clearly, this was a big cost-saver for the state,” says study co-author Jon Gruber.
The savings, says Gruber, occurred because patients with limited network coverage relied more on primary care and less on specialists. There is no sign that patients received lower quality care or that their health deteriorated.
Gruber, who had a hand in creating both the Massachusetts coverage law and the Affordable Care Act, claims the political implications of this Massachusetts limited network experiment are profound.
“There’s a lot of discussion about ObamaCare leading to more ‘limited’ choices,” says Gruber, and “isn’t that a shame.” But Gruber says people in these plans “don’t appear to be suffering.” Continue reading