Anthem announced the development of a Narrow Network in Wisconsin. The narrow network is a limited preferred provider organization (PPO). This new network arrangement is not just for Wisconsin but the entire country. The health insurance industry is working on reducing costs and one way to do this is to negotiate deeper network discounts. If an Insurance network can increase participation in a local hospital network then that gives the carrier the ability to reduce reimbursement rates.
With the development of any health insurance exchange in Indianapolis we could see the narrow network become common with those plans. If the policy is regional based then that gives the carrier the ability to negotiate.
This could benefit the Indianapolis residents from a claims and premium standpoint. If cost of care goes down then so should the premium. The negative would be members would be restricted to that narrow network. If a member was to go out of network they may still have coverage but be responsible for a much high portion of the claim. It would not be surprising if the out of network expense was based on Medicare reimbursement rates.
With any narrow network we could see a delay in care from primary care doctors. Right now in Indianapolis we have shortage in general doctors. This could become even worse the expansion of health insurance.
There will be plans in the market place that do not have these narrow networks. To the Hoosiers that can afford these plans they may choose these plans so they are not restricted in who they can see.
The cost of care is going to have to be addressed. The Government has been unsuccessful in tackling this issue. The private industry will have no choice but to come up with new approaches in reducing the cost of care.