We all remember when President Obama pointed out that you wouldn’t have to change your doctor with health reform. That’s probably true in the most expensive plans, but you can’t always eat your cake and keep it too.
We know healthcare prices vary from semi-rational to outrageous. It would be hard to get any concessions if every physician had to be in the network. So, like we’ve seen in pharmacy with some initial screaming but general acceptance, plans are going to reduce the size of their networks in return for some price concessions.
Should this be a surprise? No…unless you actually believe politicians.
Will this lead to a different set of issues around monitoring out of network use? Yes. This is something plans historically don’t do very well.