Tag: network adequacy

Stakeholder Perspectives on CMS’s 2025 Notice of Benefits and Payment Parameters: Consumer Advocates

The Biden administration will soon finalize its annual rulemaking for the Affordable Care Act Marketplaces. To better understand the impact of the proposed changes, CHIR reviewed the public comments submitted by key stakeholder groups. In the second post in a 3-part blog series, CHIR’s Karen Davenport and Emma Walsh-Alker review the feedback provided by consumer advocates.

Stakeholder Perspectives on CMS’s 2025 Notice of Benefit and Payment Parameters: Health Insurers and Brokers

The Biden administration will soon finalize its annual rulemaking for the Affordable Care Act Marketplaces. To better understand the impact of the proposed changes, CHIR reviewed the public comments submitted by key stakeholder groups. In this first in a 3-part blog series, CHIR expert Sabrina Corlette reviews the feedback provided by health insurance companies and web-brokers.

September Research Roundup: What We’re Reading

As we fall into autumn weather, CHIR continues to keep up with the latest health policy research. In September, we read about trends in individual market enrollment, mental health care networks available through the Affordable Care Act’s (ACA) Marketplace, and employers’ ability to negotiate lower prices for health care services.

February Research Roundup: What We’re Reading

Along with “Health Policy Valentines,” February brought a host of new health policy research. This month, we read about trends in medical and pharmacy spending, the relationship between health systems’ financial performance and amounts paid by commercial plans, and mental health provider network adequacy.

December Research Roundup: What We’re Reading

Happy New Year! The holiday season may be over, but health policy researchers continue to bestow gifts onto our field. In December, we read about disruptions in health insurance coverage, the uninsured population, and gaps in provider network oversight. This roundup will highlight key findings of these articles, as well as their significance for our work.

May Research Roundup: What We’re Reading

This month, the CHIR team celebrated the end of the school year with new health policy research. For the latest installment of our monthly research roundup, we reviewed studies on access to providers in Medicaid managed care networks, how the Employee Retirement Income Security Act (ERISA) affects state cost containment reforms, and the health coverage implications of the Biden administration’s recent changes to the public charge rule for immigrant communities.

Standards for Provider Network Adequacy in Medicaid and the Marketplaces

Beginning in 2023, CMS will require QHP provider networks for plans sold on the federal marketplace to meet minimum time-and-distance standards and, beginning in 2024, minimum standards for appointment wait times. CHIR joined with colleagues at the Georgetown Center for Children and Families to examine the new marketplace network adequacy standards and how they compare to Medicaid’s standards.

The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.