The report comes several months after the federal Centers for Medicare and Medicaid Services said it will closely analyze the "network adequacy" of 2016 health plans, focusing "most closely on those areas which have historically raised network adequacy concerns," including hospital systems, mental health providers, oncology providers and primary care providers.
"If CMS determines that an issuer's network may be inadequate under the reasonable access review standard, CMS will notify the issuer of the identified problem area(s) during the certification review process and will request that the issuer address the concern by adding providers to its network or submitting a justification explaining how it will provide reasonable access to enrollees," CMS said in a guidance issued in February.
Asked about the Avalere analysis, CMS spokesman Aaron Albright pointed to a trio of public surveys that found that customers of Obamacare exchanges were largely happy or satisfied with their plans. The survey by Gallup found that 1 out of every 7 people covered by an exchange-sold plan rated it as "excellent" or "good," and the Commonwealth Fund survey found that 73 percent of exchange customers said they were "very" or "somewhat" satisfied.
A survey earlier this year by J.D. Power found that satisfaction among new Obamacare enrollees "has significantly increased from 2014, and health plans obtained through the [exchanges] generate levels of member satisfaction equal to or higher than plans not obtained through the marketplace exchange."
Brian Hoyt, managing director at Berkeley Research Group, said Avalere's analysis "reflects the pressures that plans are finding to contract with providers that would perhaps accept payments they're able to provide under the exchange plans."
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Health providers who contract with Obamacare exchange insurers are generally willing to accept lower rates of reimbursement for their patients in the hope they will make up the money on the volume of patients treated, Hoyt said.
While narrow provider networks can limit customers' options for treatment under a policy, they often pay less in monthly premiums as a result, since their insurance plan has more bargaining power with providers, he added.
Hoyt, in a recent white paper for BRG, noted that even as regulators look more closely at whether insurers are offering customers enough choices in terms of providers, concerns are increasing about the accuracy of information that insurers share with consumers about the members of their network in the form of "provider directories."
"Provider directory inaccuracies represent a growing and significant risk both to consumers and health plans," Hoyt wrote in his paper. "Inaccurate directory information may limit a consumer's ability to verify if a preferred doctor is in-network, or to know how many and what types of providers would have to be accessed under a particular product offering."
Mistakes in network directories can also cost insurers money.