(Editor’s Note: Pioneer welcomes our Senior Fellow on Healthcare, Amy Lischko, to the blog. Amy will be writing on healthcare here from time to time, as well as working on research for Pioneer. Welcome.)
It’s worrisome when the state tells us what kind of provider network we need.
Today’s Globe article “Insurer told to hold off in Mass.” highlights one of the reasons behind our increasing health care costs.
Carriers have often remarked that they have difficulty creating both tiered provider networks and narrow provider networks that offer lower costs. Why can’t the state (via the Connector or DOI) allow Centene to offer these plans to consumers and let the consumers vote with their feet? If no one signs up, Centene will have to adjust its strategy.
Of course, consumers should be made aware of the network that is in the plan and let them decide if it is adequate and reasonable for the premium charged. This isn’t the first time I’ve heard of the state micro-managing the plans to protect the consumer. When I buy an airline ticket with a layover instead of a direct connection, I do so with this knowledge but I do have a choice in the matter.