Wednesday, March 30, 2016

"I think CMS [in its 2017 Benefit and Payment Parameters rule for HealthCare.gov] ...

... is trying to draw a distinction between network adequacy and narrow networks. And the two are different concepts not in conflict with one another at all. Network adequacy means that when I need a provider there is a provider available to me. And some of the literature around network adequacy has related to how far I have had to travel, whether there are all the specialists you would need in-network and am I being forced out of network to get the care I need, the personnel to serve me.... [The narrow network issue is one of choice.] It's not whether any provider is available to me, it is do I have choice among providers available to me."

— Deborah Chollet, Ph.D., fellow at Mathematica Policy Research, told AIS's Health Plan Week.

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