Dive Brief:
- Health maintenance organization (HMO) plans, which lost favor over perceptions that they limited choices for care, are regaining popularity due to their affordability, The New York Times reports.
- In an effort to improve perceptions, insurers are changing some features and at least one, Blue Cross Blue Shield of Illinois, has suggested that a new designation, such as Health Improvement Organization (HIO), should replace the term "HMO."
- The lines between different types of plans have become blurry over the past several years, but the presence of HMOs is increasing on the ACA exchanges. More than half of the ACA plans being offered now feature the types of narrow networks that were previously the hallmark of HMOs.
Dive Insight:
While HMOs are notably proliferating in the ACA marketplaces, along with similar narrow networks and ACO plans, not all consumers are pleased when their marketplace options are limited to HMOs, and employers remain largely resistant.
The lure, however, is in the savings and coordination of care afforded by the small network. Another update, typical of new HMOs, is that most no longer require a primary care physician to approve all referrals.
Some experts suggest that no matter what you call a plan, there's no escaping limited networks to get the tradeoff of managed care and lower prices.
"It's hard for me to come up with a model that doesn't limit patients to networks that are going to solve the problem," Lee Sacks, chief medical officer for Advocate Health Care, told the New York Times.