The Robert woods Johnson Foundation has issued a new issue Brief as part of their continuing coverage of Health Insurance Marketplaces: Most Regionally Ranked Hospitals Stay In-Network with Marketplace Plans, But Participation Declines.

RWJF notes that "some of the most significant changes [to HIXs] relate to provider networks and access to out-of-network providers." To address this issue, they state that "in the absence of comprehensive data, one way to gain
insight is to measure changes in network participation in marketplace plans by a fixed cohort of providers between 2015 and 2016. We selected a group of hospitals that are highly rated by one widely used measure, the U.S.
News and World Report’s list of Best Regional Hospitals in 2015."

Here's five things to know about their findings:
1. More than 95% of regionally ranked hospitals were in-network with at least one ACA marketplace plan in both 2015 and 2016.
2. Network participation decreases significantly, however, as more than half of hospitals reduce the number of networks in which they participate between 2015 and 2016.
3. The percent of hospitals in-network with only one marketplace plan increased from 7% in 2015 to 20% in 2016.
4. Network participation declined more in metro areas.
5. Customers loyal to a particular hospital can in most cases still find a marketplace plan that includes it, but choices are narrowed in 2016 relative to 2015; plans with these hospitals may be more expensive.