Narrow Networks, Access to Hospitals and Premiums

Doctors go over a patient's charts in the emergency room.

A report by the Urban Institute finds that nearly all insurers offering plans through the insurance marketplaces in six cities studied include highly ranked hospitals within their provider networks.

The Issue:

The report examines which hospitals are included within marketplace plans in six cities: Denver; New York City (Manhattan); Portland, Ore.; Providence; Baltimore; and Richmond, Va.

Key Findings

  • The size of a plan’s network is not necessarily tied to the cost of its premiums.

  • Narrow networks led to more-competitive, lower-cost premiums, yet some plans with broader networks had low premiums and some plans with narrow networks had high premiums.


The research concludes that every hospital in the cities studied is included in at least one marketplace plan network.

About the Grantee:

The Urban Institute is a nonprofit, nonpartisan policy research and educational organization that examines the social, economic and governance problems facing the nation. For more information, visit