|
Posted by
Olog-hai
on Tue Oct 7 12:35:05 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.
fiogf49gjkf0d NY Times
HealthCare.gov Still Suffers From Lack of TransparencyBy Margot Sanger-Katz
October 7, 2014The new chief executive of HealthCare.gov, Kevin Counihan, is setting expectations really high for the website’s performance during its second year of open enrollment, set to begin in mid-November. In an interview with Alex Wayne of Bloomberg News, Mr. Counihan said his goal was to create a consumer experience so satisfying that it would result in “raving fans” for the insurance shopping site
But here’s one big hurdle: The site still won’t have any tools to allow consumers to see which doctors and hospitals are covered by individual insurance plans. Mr. Counihan told Mr. Wayne that HealthCare.gov would not change to allow consumers to comparison shop on insurance plan networks.
Plans that limit patients’ choices of doctors and hospitals have turned out to be the signature product of the Affordable Care Act marketplaces. That may be a welcome development for cost-conscious consumers, but only if they know what they’re buying.
The proliferation of these plans is not a surprise. As we’ve written before, the combination of new regulations and insurers’ desire to keep prices low have made the plans, known as narrow networks, an attractive option for insurers seeking to offer affordable choices.
And evidence shows that a narrow network does not necessarily mean a bad plan. A recent study of narrow plans offered to Massachusetts state employees found that people who chose the narrow plans spent less money and seemed to have equally good health care, compared with their counterparts in more traditional plans.
But the researchers behind that study said they thought a key to the program’s success was that the employees understood the trade-offs and knowingly chose a plan with a lower premium and fewer doctors.
That may not always be the case in the federal marketplaces, where there’s no easy way to compare the doctors and hospitals that are covered by plans without researching each one individually — by calling the companies or searching on their websites. Even the dedicated shopper willing to do that extra work may find it frustrating. Insurers may offer different networks for different products, which is not always clear. The lists of hospitals and doctors are also often out of date. Journalists at The Los Angeles Times recently constructed an interactive website to allow California consumers to see which plans cover their doctors. Shoppers in other states will not be so lucky.
This year, many people appear to have signed up for narrow plans unwittingly. A survey from the health research group the Commonwealth Fund found that about 25 percent of people with new exchange plans didn’t even know whether they’d bought a narrow network plan. So far, overall satisfaction seems relatively high, though most people are still fairly new to their plans. There are consumers in some states who are suing over their inability to get the care they need.
Stories like those recently chronicled by my colleague Elizabeth Rosenthal, of patients surprised to learn after the fact that they had been treated by out-of-network doctors, seem likely to proliferate if poor transparency about networks prevails.
Given HealthCare.gov’s difficulties with basic functions last year, it’s understandable that the government is focusing on core tasks, rather than adding new tools. But the continued challenges consumers will face comparing networks could undermine a key underpinning of the marketplaces — that people should be able to shop for insurance products the way they do for airline tickets or electronics, comparing prices and features in order to select the plan that’s right for them. Who will rave about a market without transparency?
|
