http://www.youtube.com/watch?v=Q1xLY15uSQY&app=desktop
By Allison Bell – January 6, 2014 •
“PPACA started to phase in limits on how insurers could use annual benefits limits, medical underwriting and plan benefits choices to hold rates down. Insurers reacted by creating narrow, ultra-low-cost networks; narrow networks made up of providers with high quality scores (LOW FEES); and big networks (High Fees) aimed at the Cadillac plan market.”
Editor’s Note: Translation – ACA limits insurers to pre-defined “metal” plans that leave no room for cost shifting. So, how do carriers compete now? By paying providers less. Narrow networks are SBPPO’s – composed of providers who charge less than others – (type in “sbppo” in search box on this blog for information on SBPPO’s).
ACA provides high octane fuel for Cost Plus / Reference Based Pricing schemes.
Continue reading What You Need To Know About Provider Networks Under ACA