Fads come and go and now another fad has passed. Skinny is no longer in. In fact, skinny is out, as in “out-of-your-pocket.” That’s the latest news on healthcare networks. This week Anthem, a unit of Wellpoint, Inc., was sued for the second time over accusations of switching people to skinny, or narrow, networks that have a limited selection of doctors, hospitals and other service providers.
The Impact of Skinny Networks
For people not on corporate health insurance plans, the changes over the last year have been numerous. The first dramatic change came with the introduction of Obamacare. Deductibles were redefined as “paid in full, up front.” No longer did insurance assist in paying bills until the deductible was met. Now the deductible became the “paid up front amount,” after which insurance would start to contribute. This was a major cost increase that many families did not realize until after they started using their new health insurance.
Next, the arrival of the skinny network. These networks, with significantly reduced numbers of providers, shift additional costs from the insurance company to the insured. We blogged about the anticipated impact of limited provider networks during open enrollment earlier this year citing the 40% reduction in available hospitals here in New Hampshire, and predicting this would become a large hidden cost with Obamacare and a serious issue for consumers.
Getting Sued for Being Skinny
A lawsuit was filed Tuesday in the Los Angeles County Superior Court by 33 Anthem customers. The lawsuit alleges Anthem misrepresented the size of the network provided in the new plans offered under Obamacare. Anthem is California’s largest for-profit health insurance provider who has been widely recognized for having enrolled the largest number of people in the Covered California healthcare exchange earlier this year.
The Marketing of Being Skinny
Health insurers have given us a new marketing term that sounds good, but isn’t. EPO: Exclusive Provider Organization. Under the new healthcare laws companies are switching customers from Preferred Provider Organizations to Exclusive Provider Organizations. While exclusive sounds good, certainly much better than being “preferred,” watch out. What exclusive means in healthcare networks is that you have both the right and responsibility to reach into your own pocket and pay for services that you insurance company once paid on your behalf.
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