Empowering Health Care Consumers

By

Cynosure Health

Funding Area

Empowering Health Care Consumers

Date

June 19, 2019

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A review of hospital network variation in New York State. @nys_health and @CynosureHealth report on network adequacy for consumers:
Assessing the network adequacy of New York State hospitals & what variations could mean for consumers. @nys_health and @CynosureHealth report:

This NYSHealth-funded report by Cynosure Health examines the network adequacy of hospitals across all regions and markets in New York State, assessing differences in network size and clinical quality performance and what these variations could mean for consumers.

Since the implementation of the Affordable Care Act, concerns have surfaced about the adequacy of health plan networks. Although narrow networks could be a means to control costs and lower premiums, they also raise questions about consumers’ experiences with health care access and quality.

This report provides an overview of hospital network size and quality for commercial, Medicaid, and NY State of Health markets across all regions of New York State. It also offers practical recommendations for implementing new network adequacy measures and standards, which in turn could better help consumers in their decision-making process for choosing health plans or where to seek care. Among the key findings:

  • Some New York State regions offer residents access to primarily lower-quality hospital networks.
  • Differences exist in network size, both within and across plan-products.
  • There is a weak correlation between network quality and size.

Also featured are firsthand accounts of some of the key barriers and frustrations consumers experience when seeking care in a variety of settings.