Many ACA Enrollees May Lack Access To In-Network Specialists, Study Finds

Reuters (10/28, Seaman) reports that about one in seven health plans offered on the Federal marketplace in 2015 did not provide access to in-network physicians for at least one medical specialty, according to a study published in the Journal of the American Medical Association. Researchers looked at 135 plans in 34 states, finding that 18 plans in nine states lacked in-network specialists for at least one specialty within a 100-mile radius. According to the article, the most commonly excluded specialties were endocrinology, rheumatology, and psychiatry.

NPR (10/28, Kodjak) reports in its “Shots” blog that the study “was actually designed to be easy on health plans,” as it focused on the most populous areas in 34 states. Lead author Stephen Dorner, a researcher at Harvard’s T.H. Chan School of Public Health, “said it’s likely the health insurance plans in rural areas lack even more specialists, simply because there aren’t any located within 100 miles of the customers.”

The Los Angeles Times (10/28, Levey) reports Dorner “said the findings suggest that state and federal regulators need to develop clearer network adequacy standards for health plans.”

Related Links:

— “Specialized healthcare may be lacking under Obamacare plans,” Andrew Seaman, Reuters, October 27, 2015.

Posted in In The News.