New research conducted for PFC by Avalere, “The High Cost of Healthcare: Patients Experience Greater Cost-Shifting and Reduced Coverage in Exchange Markets 2014-2018,” shows that patients are experiencing higher premiums and sharp increases in patient out-of-pocket costs for health plans on exchange markets, and increasingly being offered narrow or restrictive health networks that cover between 34% and 66% fewer providers. Patients are paying more for less coverage, while doctors are being paid about the same, and insurance companies are showing record profits. And, these insurance plans with small, specialist deficient networks and high out-of-pocket costs can put patients at greater risk for receiving surprise bills, especially in an emergency when patients rely on insurance most.
The research highlights what patients across the country are experiencing with their healthcare plans – patients are paying more and getting less coverage. Regulations around network adequacy have not kept pace, but doctors and patients can end surprise bills while ensuring long-term access to quality healthcare and ending the surprise insurance gap.