Covered California health plans offer smaller hospital networks than commercial plans, a recent study reports.
The research backs up the claims of many enrollees who say their Covered California plans have narrow networks. However, the researchers add, the state marketplace plans still offer about the same level of geographic access to hospitals and in some cases allow enrollees to get care at higher quality hospitals.
“Although the hospital networks for Marketplace plans do appear to be, on average, narrower than those for the commercial plans, the Marketplace networks have comparable quality for two of the quality measures and actually have higher average quality for the third,” the report states.
The study appears in the May issue of the peer-reviewed journal Health Affairs. Researchers from the University of Wisconsin–Madison and UC Irvine obtained plan information for Covered California and commercial plans, such as those offered through employers, and compared the number of hospitals each included in their networks.
On average, the state marketplace plans had about 83 percent of the hospitals that the commercial network had.
“With only a few exceptions, marketplace networks are reduced versions of commercial networks,” the study states.
Although marketplace plans have smaller networks on average, people enrolled in them have nearly the same geographic access to hospitals, the researchers found.
The study found that 92 percent of people lived 15 miles or less from one of the hospitals in the Covered California plans. Meanwhile, the commercial plans offered hospitals near 93 percent of people.
Marketplace plans also offered access to slightly better performing hospitals than commercial plans, according to the research.