Network Adequacy

46 Pages·2016·2.75 MB·English

New Hampshire Insurance
Department
Network Adequacy
Public Information Release
Marketplace Issuer Networks for the
2017 Plan Year
November 22, 2016
Agenda (Contents)
2017 Marketplace Network Information Slide
New Hampshire Marketplace Preview 3-9
Health Insurance Carrier Network Profiles
Ambetter from NH Healthy Families, offered by Celtic Insurance 11
Anthem Blue Cross Blue Shield of New Hampshire 12
Harvard Pilgrim Health Care of New England 13-14
Minuteman Health 15
Appendix: Hospital, ECP, & SUD Listing 16
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Key Dates: 2017 Marketplace Plan Review
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Preview of Marketplace Issuer Networks
All information provided in this presentation has been generated from insurance carrier applications
and is current as of November 22, 2016.
This information does not represent final networks as they will appear on the Health Insurance
Marketplace in 2017. Carriers continually negotiate contract terms with providers, and State review
of these networks may result in changes to provider contracts or geographic coverage of health
plans.
Hospital listings reflect only those hospitals located in NH. Essential Community Providers (ECPs)
are medical care providers who serve predominantly low-income, or medically underserved patient
populations as classified by CMS under 45 CFR 156.235 of the Federal Register.
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New Hampshire Insurance Marketplace Profile
Medical Profile 2014 2015 2016 2017
1 5 5 4
• Anthem • Anthem Blue • Ambetterfrom NH • Ambetterfrom NH
Blue Cross Cross Blue Shield Healthy Families, Healthy Families,
Number of Blue Shield of New offered by Celtic offered by Celtic
of New Hampshire Insurance Insurance
Carriers Hampshire • Assurant Health • Anthem Blue • Anthem Blue
• Community Cross Blue Shield Cross Blue Shield
Health Options of New Hampshire of New Hampshire
(MCHO) • Community Health • Harvard Pilgrim
• Harvard Pilgrim Options (MCHO) Health Care of
Health Care of • Harvard Pilgrim New England
New England Health Care of • Minuteman Health
• Minuteman Health New England
Number of
• Minuteman Health
Plans 14 60 62 49
• 11 Individual • 42 Individual • 32 Individual • 32 Individual
• 3 Small Group • 18 Small Group • 30 Small Group • 17 Small Group
Hospital
16 26 26 26
Inclusion
• Acute care • Acute care • Acute care • Acute care
hospitals in hospitals in hospitals in hospitals in
QHP networks QHP networks QHP networks QHP networks
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New Hampshire Insurance Marketplace Profile
Dental Profile 2014 2015 2016 2017
3 3 4 2
• Anthem • Anthem • Anthem • Anthem
• Delta • Delta Dental • Delta Dental • Delta Dental
Number of
Dental • Guardian Life • Guardian Life
• Guardian Insurance Insurance
Carriers
Life Company Company
Insurance • Dentegra
Company Insurance
Company
Number of
22 13 15 11
Plans
• 8 Individual • 7 Individual • 8 Individual • 7 Individual
• 14 Small Group • 6 Small Group • 7 Small Group • 4 Small Group
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2017 Network Profile – Hospital Coverage
Location of Hospitals in New Hampshire New Hampshire Hospitals
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2017 Network Profile – Hospital Coverage
Each hospital appears in at least 1 issuer network in
Network Contracts per Hospital
2017, with several plans offering coverage at each facility
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2017 Network Profile – SUD Treatment
The New Hampshire Insurance Department, in a new initiative for 2017,
provided a list of providers in seven SUD treatment categories requesting that
carriers indicate which providers were included in their proposed network(s).
The seven SUD treatment categories provided were:
 Intensive Outpatient Program
 Partial Hospitalization
 Residential Services
 Medication Assisted Treatment (MAT) – Buprenorphine (Suboxone)
 MAT – Methadone
 MAT – Naltrexone (Vivitrol)
 MAT – Other Medication
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2017 Network Profile – SUD Treatment
 The template provided by the Department included108 SUD treatment
providers throughout the state of New Hampshire. The data set can be
found in the Appendix, starting on slide 16.
 The 108 providers listed were generated from a Department created data
set aimed at gathering a snapshot of network coverage by SUD treatment
category.
 This may not reflect the full breadth of each carrier’s SUD coverage by
treatment category. For additional information on the providers included in
an issuers’ network please consult the carrier’s provider directory.
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