Marketplace plans' provider networks are just not adequate without family planning centers
Guttmacher Inst
Marketplace plans' provider networks are just not adequate without family planning centers
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FAMILY PLANNING CENTERS ARE A KEY ASSET FOR ACA INSURANCE PLANS
These Providers Can Help Marketplace Plans
Meet Provider Network Standards,
But Federal and State Policymakers Must
Do More to Ensure Their Inclusion
Securing provider networks capable of meeting the health care needs of enrollees is a crucial step in translating coverage provided under the Affordable Care Act (ACA) into accessible health services. A new analysis in the Guttmacher Policy Review argues that developing more robust standards of network adequacy is vital to fulfilling the health care needs of all marketplace plan enrollees, and that publicly supported family planning centers are well-positioned to help plans meet many of these standards.
The ACA requires that marketplace plans provide enrollees with reasonable access to care by maintaining a network that is sufficient in the number and type of providers it includes. As part of this network adequacy requirement, plans must include safety-net providers—referred to as essential community providers (ECPs)—that serve predominantly low-income, medically underserved communities. The requirement is intended to ensure that these providers and the people they serve, the very people who are meant to benefit most from the ACA’s coverage expansions, do not get left behind.
“Family planning centers are key access points for many people the ACA connects to care,” says Kinsey Hasstedt, lead author of the new analysis. “Because of their sheer numbers, vast geographic distribution and long track record of making high-quality services available to millions of people, publicly supported family planning centers are especially well-placed to provide enrollees with the care they need. In addition, it benefits health plans to include these providers in their networks.”
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