While the ACA has encouraged the U.S. healthcare system to become more consumer-focused, a recent online survey, conducted by Harris Poll on behalf of SCIO Health Analytics®, revealed that many insured Americans do not have a clear understanding of what healthcare services are covered under their current plan, and have avoided visiting a doctor for a general health concern within the past 12 months because of cost concerns.
An infographic by SCIO Health Analytics delves into the study's findings, with a look at the number of individuals who did not seek medical care due to cost concerns, the impact of this avoidance and how health plans can use big data to provide appropriate guidance to healthcare consumers.
Narrow networks — for both medical and pharmacy providers — are gradually becoming more accepted by carriers, plan sponsors and patients. Smaller provider networks allow payers to manage overall healthcare costs while still maintaining access to benefits — an important consideration as plan designs become more commoditized in the age of public and private health insurance exchanges.
Narrow Network Strategies and Trends for Health Plans and PBMs outlines the tactics health plans are using to restrict medical and pharmacy networks while still maintaining adequate access to care and positive relationships with providers. It also summarizes case studies of health plans and PBMs that have formed narrow networks and the results they’ve seen.
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