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Old 10-22-2013, 05:08 PM   #21
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Editing a previous post. Yes, it is impossible to compare policies if you don't know what the negotiated rates are. And the insurers are under no obligation to declare each negotiated rate.
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Old 10-23-2013, 01:38 PM   #22
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Originally Posted by MichaelB View Post

My sense is this is something that is being talked about but there is no data to back it up. In other words, more of a lobby talking point, not too different from what we hear about Medicare rates.
Not sure what you mean about Medicare rates being just a "talking point" with "no data to back it up". Medicare rates are within the public domain
& widely discussed. For example, actual state-specific Medicare payment rates for many common office services are available from US gov't here (2012)-

https://www.cms.gov/Research-Statist...Physician.html

Re Exchange Plan provider fees- It is not surprising that these are not published given the long-standing position of the FTC strongly DIScouraging providers from openly discussing specific charge/payment data. To be covered under FTC "safe haven" from antitrust prosecution, providers fee info "available" to competitors must be collected by a 3rd party and be more than 3 mo old.

Competition in the Health Care Marketplace - Industry Guidance - Statements of Health Care Antitrust Enforcement Policy

Thus, for now the only "data" the public is likely to see on this is from large independent surveys (e.g. MGMA). IMHO- This makes NO sense when gov't is expecting folks to consider cost-containment when shopping for their Exchange Plan.
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Old 10-25-2013, 07:36 PM   #23
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I think it is impossible to compare the plans because it seems very hard to me to figure out if the plan would allow me to see a particular doctor. That doctor being in said insurance company's network is not enough. The doctor might refuse to accept the rates paid by that particular Obamacare plan so the plan would be useless. On the NY state obamacare site the widget that allows one to check if a certain doctor is available in a plan does not work and I suspect never will.
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Old 10-25-2013, 07:53 PM   #24
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I think it is impossible to compare the plans because it seems very hard to me to figure out if the plan would allow me to see a particular doctor. That doctor being in said insurance company's network is not enough. The doctor might refuse to accept the rates paid by that particular Obamacare plan so the plan would be useless. On the NY state obamacare site the widget that allows one to check if a certain doctor is available in a plan does not work and I suspect never will.
Are you looking at cost sharing or just subsidy plans? I suspect there might be a provider network difference between the two. The question might be do the same plans show up in cases above and below that threshold, or even above and below the subsidy threshold. I can see that the network for the cost sharing plans might be smaller than just the subisdy plan.
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