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Association Calls for Greater ECP Inclusion in Marketplaces

In Jan. 13 comments to the Center for Consumer Information and Insurance Oversight (CCIIO), America’s Essential Hospitals called for more robust standards to ensure that health insurance marketplace plans include essential community providers (ECPs).

The association’s comments responded to a draft 2017 letter from CCIIO to issuers in the federally facilitated marketplaces. America’s Essential Hospitals urged CCIIO to require qualified health plan (QHP) issuers to offer contracts in good faith to every willing ECP hospital in each county of the QHP’s service area. Excluding essential hospitals from QHP networks limits vulnerable patients’ access to vital health services and coordinated care, the association said.

The association also asked CCIIO to monitor QHP contracts to ensure that issuers offer ECP hospitals adequate payment rates to support the complex services that they provide. Essential hospitals offer extensive and vital services that many non-ECP hospitals do not. Adequate payment rates ensure that essential hospitals are able to provide access for low-income patient populations without continuing to face unsustainable levels of uncompensated care.

Contact Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202-585-0127.

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About the Author

Matt Buechner is the policy and advocacy associate for America's Essential Hospitals.

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