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Narrow Networks: Does Limited Choice of Hospitals Affect Quality in Covered California?

Bruce Spurlock

Individual health insurance coverage is trending toward plans that limit hospital options. What does this mean for Covered California members in terms of quality?

Health exchanges across the US, including Covered California, are trending toward narrower networks — meaning that plans offer a limited choice of hospitals in order to enable lower premiums. It is known that consumers value low monthly premiums more than other plan characteristics such as keeping one's current doctor, coverage of a wide selection of brand-name drugs, or access to prestigious institutions. But is quality affected by the narrowness of networks in Covered California?

The research discussed in this issue brief sought to determine whether there was a relationship between quality performance and other network attributes such as cost or geographic location.

The research team, headed by Bruce Spurlock, MD, president and CEO of Cynosure Health Solutions, found that there were not significant differences in the quality of care delivered by hospitals offered through the Covered California plans.

They concluded that consumers can choose among different plan-products with high confidence that they will receive generally equivalent hospital care.

The complete issue brief is available as a Document Download.

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