Physicians Are Leery of Exchange Participation

Some observers have commented on the narrow networks associated with many insurance products being offered by the state and federal insurance exchanges mandated by the Patient Protection and Affordable Care Act (PPACA). A new survey¹ of members of the Medical Group Management Association (MGMA) suggests why insurers may be having trouble attracting broader physician panels. The MGMA received more than 1,000 responses from practices representing more than 47,500 physicians. More than half of respondents believe that PPACA exchanges will have an unfavorable effect on their practices. Just 29.2% plan to participate in products associated with the exchanges, while 40.2% are evaluating participation, suggesting that they might sign on, ultimately.

Table Why Practices Are Not Participating¹

Of those participating, 57.7% will do so to remain competitive in their local markets, and 26.8% cite all-products contract clauses that require participation. More than half (51.2%) say that the opportunity to replace charity care (when uninsured patients obtain coverage) is a factor.