Dr. Anthony LoSasso, Professor in Health Policy and Administration at the University of Illinois at Chicago School of Public Health, received a 3-year award totaling just over $1 million from the Agency for Healthcare Research and Quality (AHRQ) to address the effects of narrower network health insurance plan designs on cost, utilization, quality, and access to care. In the wake of the Affordable Care Act (ACA), the use of narrow network health plans has emerged as a popular strategy to contain costs. While these plans differ, they generally offer lower premiums in exchange for a limited group of in-network providers to choose from.
[Photo: Dr. Anthony LoSasso]
“There is a lot of focus on network size nowadays, along with a lot of concerns around the adequacy of coverage as these plans become more common. The worry, really, is that people might find it more difficult to access care,” Dr. LoSasso explained.
Furthermore, there is a “parallel trend” being witnessed in the employer-sponsored market, which will be the main focus of the study. “We’re looking at small businesses and companies who, generally, have 2 to 50 employees. This is a very sensitive market, representing a segment of employers that has the lowest rates of offering health insurance, a segment that is exempt from the employer mandate in the ACA,” Dr. LoSasso observed.
Detailed data will be obtained from a major national health insurer including, but not limited to, enrollment information, demographic information, plan details (deductible, out-of-pocket maximum, coinsurance, etc.), provider network information, and health care claims data. The data will feature a large number of companies two years prior to the introduction of the narrow network plans through two years after the introduction. Researchers will then use the data to compare the experience with narrow network plans to a set of employers who stayed with traditional network plans during the same period.
By examining an often overlooked segment of employers in the private sector, this research will provide more comprehensive information on a topic with high bearing on health care policy.