CHICAGO, Sept. 22, 2016 — Provider Network IQ, the first provider network analytics solution for insurance plans in the Federal Marketplace was released today. The product, created by NORC at the University of Chicago, helps plans gain insights into how their provider networks compare to others in their markets. Health plans can use this information to build smarter networks and achieve greater efficiency, providing significant advantages for both the health plans and the consumers they cover. The product will also make it easier for insurers to keep pace with new federal and state requirements for network adequacy and transparency.

“Across health insurance markets, insurers are struggling to achieve the optimal network size and structure,” said Michelle Strollo, associate director, Health Care department at NORC. “On one hand, a narrower network reduces cost to the plan and allows a lower premium for consumers. On the other, these cost savings have to be weighed against the quality and availability of service. Provider Network IQ is a powerful new tool that gives plans the data they need to achieve the right balance within their markets.”

Leveraging the new data and analytics capabilities available in Provider Network IQ, NORC has also completed an analysis of provider networks across the Federal Marketplace. The analysis, Assessing the State of Provider Networks in Federally Facilitated Marketplaces, highlights implications of provider network transparency initiatives and their impact on the Federal Marketplace. The Centers for Medicare & Medicaid Services recently announced plans to pilot a new measure of network breadth known as the Provider Participation Rate in 2017. Through its analysis of 2016 Federal Marketplace health plan data, NORC found that under this new measure, 15 percent of adult primary care networks would be classified as basic (narrow), and 11 percent would be classified as broad. However, NORC found substantial variation, both across and within states, in what counts as a broad or basic network, illustrating the difficulty in establishing a standard metric for provider network breadth. NORC will continue to study the impact of these new standards and other policy changes designed to improve transparency and ensure network adequacy on health insurance markets.