Dive Brief:
- A new analysis by the Robert Wood Johnson Foundation looks at how many hospitals included on U.S. News & World Report’s list of Best Regional Hospitals are accessible via marketplace health plans.
- It found of those 156 regionally ranked hospitals, more than 95% participated in at least one marketplace plan in both 2015 and 2016.
- However, it also found network participation has notably decreased, with more than half of those hospitals cutting the number of plan networks in which they participated between 2015 and 2016.
Dive Insight:
Currently, top hospitals' participation in marketplace plan networks is keeping the marketplace plans on par with private plans, addressing some concerns over the narrow network trend.
“Some people were starting to say that marketplace coverage is second-tier coverage,” Kaiser Health News quoted study author Katherine Hempstead. However, her findings refute some of that sentiment. “The cost-sharing might be more aggressive [in marketplace plans], but they’re not that dissimilar,” she said.
The issue is whether those top hospitals will maintain current participation levels or continue to drop off. The number participating in only one plan shot up from 7% to 20% over just one year. Meanwhile, 43% maintained or increased their participation over that time.
Much of the matter is regional, the report notes, with some states seeing steep declines while others have stayed the course or gone up.
Part of the puzzle, Hempstead noted, is why hospital participation is declining, which is something the current report does not examine.