Implementation of the Affordable Care Act: Six-State Case Study on Network Adequacy

During the transition to new health plans and new marketplaces under the ACA, many insurers revamped their approach to network design, and many now offer narrower provider networks than they have in the past. In this study for the Robert Wood Johnson Foundation’s project to monitor ACA implementation, researchers assessed network changes and efforts at regulatory oversight in six states: Colorado, Maryland, New York, Oregon, Rhode Island, and Virginia. Researchers found that insurers made significant changes to the provider networks of their individual market plans, both inside and outside the marketplaces, and that insurers took varying approaches to network design.