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Publications
  • September 2017
  • Editorial
  • Journal of Clinical Oncology

Helping Patients with Cancer Navigate Narrow Networks

By: Stephen M. Schleicher, Emeline M. Aviki and Thomas W. Feeley
  • Format:Print
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Abstract

The Affordable Care Act of 2010 (ACA) was designed primarily to improve patient access to affordable health care. The access-expanding provisions of the ACA included federal- and state-based health insurance exchanges with minimum coverage requirements and preexisting disease protection clauses. One effect of these access-expanding measures has been increased costs for insurers. Narrow networks, which limit patient access to certain hospitals and physician groups, represent a strategy for insurers to remain competitive in the face of increased costs. Narrow networks lower insurance premiums, in part by funneling patients toward lower-cost providers. We previously hypothesized that narrow networks might be used to adversely select against the enrollment of patients with costly chronic diseases like cancer and found that narrow networks commonly excluded stand-alone cancer hospitals, such as Memorial Sloan Kettering Cancer Center and the University of Texas MD Anderson Cancer Center. The exclusion of National Center Institute (NCI) designated cancer centers from narrow health plans is a symptom that our cancer care delivery system remains broken after the ACA. Whether we see a replacement for the ACA or a completely new health care law, the focus moving forward should be on transparency, insurance literacy, and value for patients—the best outcomes at the lowest cost.

Keywords

Health Care And Treatment; Insurance; Problems And Challenges; United States

Citation

Schleicher, Stephen M., Emeline M. Aviki, and Thomas W. Feeley. "Helping Patients with Cancer Navigate Narrow Networks." Journal of Clinical Oncology 35, no. 27 (September 2017): 3095–3096.
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About The Author

Thomas W. Feeley

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More from the Authors
  • Utilizing Time-driven Activity-based Costing to Determine Open Radical Cystectomy and Ileal Conduit Surgical Episode Cost Drivers By: Janet Baack Kukreja, Mohamed A. Seif, Marissa W. Merry, James R. Incalcaterra, Ashish M. Kamat, Colin P. Dinney, Jay B. Shah, Thomas W. Feeley and Neema Navai
  • COVID-19 Hasn't Been a Tipping Point for Value-Based Care, but It Should Be By: Thomas W. Feeley
  • 4 Strategies to Make Telehealth Work for Elderly Patients By: Umar Ikram, Susanna Gallani, Jose F. Figueroa and Thomas W. Feeley
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