Physician Network Transparency

How Easy Is it for Consumers to Know What They Are Buying?

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There is significant room for improvement in physician search functionality both at the state-Marketplace level and at the individual-insurer level.

Urban Institute researchers studied nine marketplace websites (California, Colorado, Connecticut, District of Columbia, Massachusetts, Minnesota, Oregon, Rhode Island and Washington) and healthcare.gov, and offer recommendations on how to improve the transparency of the marketplace sites. Recommendations include creating clear and accurate “hover over” definitions of plan and network types and sizes for consumers scrolling over specific plans, and creating fully functional physician directories for each plan within the marketplace website.

Key Findings

  • Most websites studied did not list plan (e.g. HMO) or network (e.g., narrow or tiered) type.

  • Only three of nine websites studied embedded provider directories for each plan on the Marketplace website.

  • The remaining websites diverted consumers to insurance company websites in order to access provider directories.

This report shows that states need to make improvements in the clarity, accessibility and functionality of their online insurance marketplaces to make them more consumer-friendly and transparent.