Health Policy$ense

How Wide Are Your Physician Networks?

T-Shirt Sizing Networks by State and Rating Area

In June, we described the first attempt to measure, in a consumer-friendly way, the breadth of physician networks offered by all silver plans on the 2014 health insurance marketplaces. We estimated network size based on the fraction of office-based physicians participating in the network within relevant rating areas in the state. We categorized networks using "T-shirt" sizes:  x-small (less than 10%), small (10%-25%), medium (25%-40%), large (40%-60%), and x-large (more than 60%). We found that nationally, 41% of all networks were either “small” or “x-small”. For simplicity, we combined these two t-shirt sizes as our definition of a narrow network. In our new Data Brief, we take a closer look at the state variation in network size.

We find dramatic state variation in the prevalence of narrow networks on the health insurance marketplace. There were 12 states with no narrow networks and 10 states with more than 60% of their networks meeting our threshold of narrow.  The map below distinguishes states by the prevalence of their narrow networks:

 

 

To a certain extent, aggregating ourdata by state obscures the variation by rating area, which is the level at which consumers choose a plan on the health insurance marketplace. Our data, by rating area, show pockets of high and low prevalence of narrow networks within states.

Our brief has lots of tables and figures with state-specific information.  Go read it here.