Rural-Urban Differences in Insurer Participation, Premiums, Health Plan Provider Networks in Federal and State Marketplaces

Year(s) Funded:
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Project Lead: Ira Moscovice

Many pressing needs exist for timely research to assist policymakers in ensuring that Marketplaces achieve success, particularly in rural communities, which have historically faced limited health insurance choices. Rural areas may be further affected by the construction of rate setting areas which restrict price differences across areas but allow insurers to offer products in subsets of counties within rating areas. Network scope and adequacy are especially important in rural areas with fewer providers and greater distances between providers. The purpose of this project is to: 1) measure the size, scope, and composition of provider networks affiliated with Marketplace plans and how these differ in rural versus urban areas; 2) analyze the relationships between network size and composition, other benefit design attributes, geographic rating area designations, and premiums; 3) examine rural-urban differences in Marketplace-based plan enrollment and how enrollment is affected by plan availability and provider network size and scope.

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