A reputable industry newsletter featured an interview with the leader of a major insurer in NY, discussing their performance for the past 2 years and plans for the future.
Point is, this insurer has already developed and implemented tiered networks for municipal plans, called the "HMO Preferred Plan" (not to be confused with a "Preferred Provider Organization").
If you visit certain providers at certain facilities, co-pays are waived. But, everywhere else you go, they're higher than normal (about triple).
As of Feb, 2016, about 60% of the members enrolled on this plan were using one of these preferred providers. 36 facilities, 400 physicians (general and specialists), state wide. A lot of people are being driven to a very small network.
This creates about a 3% premium savings, and a whole lot more explaining.
As we've seen many times over in the past few years, NY is often the first place changes occur before spreading nationwide. Keep an eye out for Preferred Provider HMO plans coming to you soon.
Point is, this insurer has already developed and implemented tiered networks for municipal plans, called the "HMO Preferred Plan" (not to be confused with a "Preferred Provider Organization").
If you visit certain providers at certain facilities, co-pays are waived. But, everywhere else you go, they're higher than normal (about triple).
As of Feb, 2016, about 60% of the members enrolled on this plan were using one of these preferred providers. 36 facilities, 400 physicians (general and specialists), state wide. A lot of people are being driven to a very small network.
This creates about a 3% premium savings, and a whole lot more explaining.
As we've seen many times over in the past few years, NY is often the first place changes occur before spreading nationwide. Keep an eye out for Preferred Provider HMO plans coming to you soon.
