In recent months, there has been significant discussion among cancer patients, their physicians and other health care providers, and cancer organizations about the adequacy of the provider networks in their insurance plans. Cancer patients want assurances that they will receive quality care and can seek second opinions from those with expertise in their particular cancer. And those with complicated cancer diagnoses have expressed concerns about their ability to receive the best possible care. There is a concern among cancer patient advocates that insurers’ limits on networks, which some fear will become more severe in some exchange plans, could be the obstacle to receiving the care they need.
In an opinion piece in the New York Times, Ezekiel J. Emanuel recommends steps that might assure that networks are adequate and that networks are evaluated for quality, with those quality assessments easily accessible by consumers. Finally, he recommends that insurers provide a “safety valve” provision that would allow those with serious conditions to obtain a second opinion at a center of excellence without shouldering out-of-network cost-sharing responsibilities.