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Comment & Response
December 8, 2015

Network Adequacy Standards and Health Insurance—Reply

Author Affiliations
  • 1Department of Political Science, University of Wisconsin, Madison
  • 2La Follette School of Public Affairs, University of Wisconsin, Madison
  • 3Department of Medicine, University of California, Irvine

Copyright 2015 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA. 2015;314(22):2415. doi:10.1001/jama.2015.15076

In Reply The ACA deserves credit for bringing new emphasis to the debate about network adequacy standards—many types of insurance in many states are currently not subject to any adequacy standards at all. We remain convinced of the potential for narrow networks to improve the quality of care and contain costs.

However, as Dr Weiss notes, they equally hold the potential to limit access inappropriately and to cause significant harm, financial or healthwise. Discrepancies between the network status of hospitals and hospital-based physicians offer one such particularly negative example that may confuse even well-informed consumers.