Network Adequacy

One of the major goals of the Affordable Care Act was to make health care affordable, while providing a base level coverage. One of the ways this was done, was for insurers to create provider networks that were not as large as they usually are. Because of this, consumers are not always able to have their medical needs met, leading to higher costs for consumers and decreased access to care. Another concern with insurers is the quality of the information they provide about their provider networks. Many provider directories are updated annually, when provider information changes much more routinely than that. This causes problems, when consumers are trying to be compliant and see providers that are in their networks. Consumers can get charged out of network prices because of incorrect information.