Breadth and Exclusivity of Hospital and Physician Networks in US Insurance Markets

Key Points Question How does the breadth of health care networks and the degree to which they overlap vary within and across specialties and insurance markets? Findings In this cross-sectional study of 1192 health care networks, large-group employer networks were broader than small-group employer, marketplace, Medicare Advantage, and Medicaid managed care networks. In many states, narrower networks had as much, if not more, overlap across different insurers’ networks than the broadest networks; areas with less concentrated insurance, physician, and hospital markets had narrower and more exclusive networks. Meaning These findings suggest that the structure of plan networks may be a factor in determining care affordability and continuity in the United States, particularly given how frequently individuals change insurance plans.