01-September-2016

In an article for Inside CMS, FaegreBD Consulting Senior Director Mike Adelberg shared his thoughts on why the Centers for Medicare and Medicaid Services (CMS) decided to reduce its new provider network rating initiative for the federally-run exchanges down to six states. The network rating system will provide consumers with comparative information on the size of competing plan provider networks in the same county in three provider categories: adult primary care, pediatricians and hospitals. But the comparative approach is weakened by insurer decisions not to participate in the exchanges in 2017.

"With fewer issuers and fewer plans, the usefulness of the network ratings suffer,” said Adelberg. “CMS is wise to step back from a national roll out this year.”

The full article is available for subscribers.

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