SECTION14. EMPLOYERPRACTICESANDHEALTHPLANNETWORKS PROVIDERNETWORKS Firmsandhealthplanscanstructuretheirnetworksofprovidersandtheircostsharingtoencourageenrolleestouseproviders whoarelowercostorwhoprovidebettercare. Atieredorhigh-performancenetworkgroupsprovidersinthenetworkbased onthecost,qualityand/orefficiencyofthecaretheydeliver. Thesenetworksencourageenrolleestovisitpreferreddoctorsby either restricting networks to efficient providers, or by having different cost sharing requirements based on the provider’s tier. • Twelvepercentoffirmswith50ormoreworkersthatofferhealthbenefitsincludeahigh-performanceortieredprovider networkintheirhealthplanwiththelargestenrollment,asimilarpercentagetolastyear[Figures14.6and14.7]. • Firmswith1,000-4,999workers(23%)andfirmswith5,000ormoreworkers(31%)aremorelikelytoincorporatea high-performanceortierednetworkintotheirlargestplan[Figure14.6]. • Eightpercentoffirmsofferinghealthbenefitsreportthattheyofferaplanthattheyconsideredtobeanarrownetwork plan, similar to the percentage reported last year [Figures 14.4]. Narrow network plans limit the number of providers whocanparticipateinordertoreducecosts. NarrownetworkplansaregenerallymorerestrictivethanstandardHMO networks. – Firmswith5,000ormoreworkersofferinghealthbenefitsaremorelikelytoofferatleastoneplanwithanarrow networkthanfirmsofothersizes[Figure14.4]. • Six percent of firms offeringhealthbenefitssaidthateithertheyortheirinsurereliminatedahospitalorhealthsystem fromaprovidernetworkinordertoreducetheplan’scostduringthelastyear[Figure14.4]. The Kaiser Family Foundation and Health Research & Educational Trust / Page 212