Study: Fewer exchange plans providing out-of-network benefits

Only 29 percent of health plans in the individual market included out-of-network coverage in 2018, down from 58 percent in 2015, according to an analysis by the Robert Wood Johnson Foundation. “National commercial carriers, which are more likely to offer broader network plans, exited the individual market in droves in 2016 and 2017, leaving a market that is dominated by Blues and Medicaid-managed care organizations,” the report notes. “MMCO plans almost always offer closed-network plans, and even many Blues plans have shifted to narrow network offerings in the individual market.” In the small group market, 64 percent of plans included out-of-network benefits in 2018, down from 71 percent in 2015. UnitedHealthcare, which largely exited the individual market in 2017, recently announced it will drop Envision Healthcare, a large provider of hospital-based physicians, from its networks effective Jan. 1.