Re: New Hampshire's marketplace grows
so unless these insurance companies are going to pay more than what antham is trying to pay (which means higher premiums) there is no reason for
doctors or hospitals to accept their plans either.
Perhaps, perhaps not. New Hampshire's premiums
were below the national average this year (their average silver plan there was almost 10% cheaper than the national average for a silver plan, and something like 19% cheaper when it comes to the bronze tier). If you're correct that Anthem's network is already offering the lowest possible premiums, then the worst case scenario is simply that consumers have more options next year, including the option to pay more for a wider network or similar rates for the same or a comparable provider network.
The question is how smart Anthem was about designing its network this year. Does the narrowness of their New Hampshire network result in greater value? With no competition last year, it's entirely possibly they were a bit sloppy and
didn't do a particularly good job balancing network size with costs. In other words, could they have (or could other insurers) have gotten more for less or a comparable amount?
Several hospital executives left out of the network said Anthem, a for-profit Blue Cross Blue Shield subsidiary of Wellpoint, never approached them about being included at a lower rate. They said they would have accepted.
“Anthem did not negotiate with us, did not even contact us. They basically red-lined us on their own,” said Charles White, chief administrative officer of Upper Connecticut Valley Hospital, which serves the northern part of Coos County. The county has the worst health outcomes in the state because of high rates of smoking, teen pregnancy, alcoholism, and obesity.
That's part of the value of having competitors. Innovations in benefit and network design become more apt to promote value when consumers have competing options to choose from and insurers have to stay sharp to gain or maintain market share.
As the article also notes, Anthem also offered a narrow network in Maine, while its sole competitor there, the co-op Maine Community Health Options, offered a broader network. (Maine's market will expand next year to include at least one more competitor, Harvard Pilgrim.)
Anthem has also narrowed its hospital network in southern Maine, reducing premiums by 12 percent, but consumers there may choose a second insurance carrier in the marketplace [the co-op] that includes all hospitals.
Yet there was
no appreciable differential in their premiums and the co-op ended up scooping up 80% of the Maine market despite not existing a year prior; the co-op's success is in fact the reason it's not able to begin expanding beyond Maine to sell plans in the New Hampshire marketplace next year.
Rates [for 2014] were similar between Anthem and the Maine co-op, according to Maine Bureau of Insurance filings.
In other words, assuming the co-op (or any of the other new entrants to New Hampshire's marketplace) can't offer a broader network at comparable prices gives 1) the new competitors too little credit, and 2) Anthem too much credit, given it faced no competitive pressures last year. It's possible that's the case and Anthem is already doing as well as any insurer could, but ensuring it's true--not to mention giving people more options--is the point of competition. Which New Hampshire's marketplace will have lots of next year. As their insurance commissioner noted, they'll have more choices of carriers, plans, and networks next year, no doubt spanning a range of premiums.
That's good for NH. But... I don't see how this could be the least unexpected.
It's not unexpected. The marketplaces are expected to continue adding consumers and sellers as they ramp up over the first couple years. These markets have been built from the group up and they're going to continue evolving and improving as time goes on. New Hampshire's just a particularly poignant example. They're certainly not unique in getting more competitive in Year 2.
