Saturday, August 30, 2014

On Narrow Networks in Healthcare

Interesting article on Narrow Networks, I agree with the reasoning. My theory of narrow networks is, for the most part, restricting people’s choice of physicians does not hurt, and can help, their health, at the same time taking cost out of the system. Consumers are notoriously poorly equipped to assess the quality of their physician.

If you told me tomorrow I had to switch PCPs and it would cut my premium share 10%, and I wouldn't have to travel any farther for my new PCP, I’d say “bring it on”. I know there are exceptions, people with complex conditions, or seeing a physician who has a rare specialization—those people are poor candidates for narrow networks. I’m talking the 90% mainstream.

The one big gotcha to find a way to avoid, with Narrow Networks—or at least make sure the buyer is aware of what they are getting--is geographic inconvenience. So while I would switch PCPs In a heartbeat, I would be more unhappy if I had to drive 5-10 miles out of the way to see the nearest provider. 

There is a movement in healthcare to create tools to compare and estimate consumer medical expenses. My personal experience with these is that they aren't that useful, for various reasons, notably statistically insufficient input data. But I do think these tools could be very useful for informing a consumer before they commit to a Narrow Network. 

It would be awesome if a tool could mine my family’s last 3 years’ worth of medical visits, and calculate the impact on distance to narrow network providers. E.g., “we estimate that if you had been in the narrow network, you would have had to travel the following distances to find the nearest network provider”…then list them out and total them up.

No comments:

Post a Comment