What Constitutes An Adequate Provider Network For Rural Health Populations?
Statement of the Problem: The issue of narrow provider networks has become more serious as a result of the implementation of the ACA and the uncomfortable balance that needs to be made between reducing healthcare expenditures and providing local access to care.
Project Goals: The purpose of this study is to develop norms/standards for provider network adequacy for rural populations (which may vary across different rural environments) that will be useful to consumers, providers, and policymakers in the decisions they face with respect to health plan choices, participation, and policies.
Methods: We will use a literature review, analysis of state and federal network adequacy standards, structured interviews with key stakeholders and an expert panel to develop provider network adequacy standards to serve rural populations. We will then test the standards using 2014 data on provider network composition in six states.
Regulating Network Adequacy for Rural Populations: Perspectives of Five States
University of Minnesota Rural Health Research Center
The purpose of this study was to examine how five geographically-diverse states with significant rural populations define "network adequacy" and the degree to which they consider rural issues when regulating networks.