In the current, post Affordable
Care Act (ACA) world, the term - “narrow network” – is often heard, and at
times, is a strategy deployed by employers and insurers. There are
a variety of other ways to describe narrow networks, such as - carve out
network; exclusive provider network; select network; tiered network…you get the
idea. From a covered member's standpoint, this strategy involves limiting
the number of contracted providers plan members can seek care from, and in return,
receive the best benefits, and lowest out of pocket costs. From the standpoint of the insurer or employer, narrow networks mitigate risk and reduce expenses. Readers who have been around the healthcare
scene since the eighties might recall the original introduction of narrow networks, albeit presented at the time as “HMO Lite”; “a
PPO/HMO hybrid”; or more commonly – “exclusive
provider organization”, replete with its very own acronym - EPO!
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