Journal Article

California Hospital Networks Are Narrower In Marketplace Than In Commercial Plans, But Access And Quality Are Similar

Haeder, Simon F, Weimer, David L, Mukamel, Dana B

2015

Overview

In this analysis the authors compared the hospital networks available to California consumers in two types of insurance in the initial Marketplace enrollment period: private commercial coverage and coverage obtained through the state insurance Marketplace, called Covered California. They gathered data from Covered California to identify insurers that were offering plans and to identify their associated hospitals. They found insurers in each region that offered comparable plans through both Covered California and the commercial market. The resulting dyads of plans hold constant region, insurer, and plan type, which allows for a direct comparison of networks. They then compared the networks in terms of percentages of hospitals in the region, percentages of residents in the region within hospital markets, and average quality of included hospitals using three different quality measures. Although the hospital networks for Marketplace plans do appear to be, on average, narrower than those for the commercial plans, the Marketplace networks have comparable quality for two of the quality measures and actually have higher average quality for the third.

• Publisher: The People to People Health Foundation, Inc., Project HOPE
• Subject: Averages / Childrens health insurance programs / Commercial markets / Consumers / Enrollments / Health care networks / Health care policy / Health insurance / Health maintenance organizations / HMOs / Hospitals / Insurance / Insurance coverage / Insurance policies / Markets / Medicaid / Networks / Patient Protection & Affordable Care Act 2010-US / Physicians / Quality of care / Regions / State insurance / Studies