As Covered California gears up for its second open enrollment period, narrow physician networks are likely to remain a concern.
At least two major health plans will offer more restricted physician networks next year. Consumer groups are concerned that policyholders will not have adequate access to care.
Both HealthNet and Blue Shield have proposed plans with smaller provider networks for 2015. HealthNet says the change is needed to keep its product affordable.
Anthony Wright, executive director of the nonprofit group Health Access California, said the total number of network providers isn’t the issue.
“I don’t think that most consumers care that there is 2,000 versus 4,000 doctors in a given network," Wright explained. "What they care about is, 'Can that insurer get me the care I need, when I need it, where I need it?'”
Covered California's Dana Howard said the exchange is concerned with keeping plan prices reasonable, while at the same time making sure that there's an ample supply of doctors and hospitals on each network.
But he added the California Department of Managed Health Care is the ultimate judge of whether the networks are adequate.
The department launched an investigation earlier this year, after receiving hundreds of consumer complaints about difficulties in finding network providers.
Gov. Jerry Brown recently signed a bill into law that will require state regulators to annually review health plans to ensure they're providing timely access to care.
