Women and Health Reform

Ensuring the Health Care Needs of Women: Resources for Health Exchanges


Network Adequacy

Questions to consider:


 How will your state address the ACA’s network adequacy requirement in terms of provider type and supply?


 What certification standards will be required for QHPs and do theseensure that the range of providers, including ECPs, such as family planning clinics, community health centers and other clinics, is broad enough to meet the health needs of women across the lifespan (e.g., Ob/Gyn, Geriatrics)?

Lessons Learned:

Blue Cross Blue Shield Foundation of Massachusetts, Network Adequacy in the Commonwealth Care Program

Families USA, Consumer-Friendly Standards for Qualified Health Plans in Exchanges: Examples from the States

Guttmacher Institute, Working Successfully with Health Plans: An Imperative for Family Planning Centers

Further Reading:

Guttmacher Institute, Specialized Family Planning Clinics in the United States: Why Women Choose Them and Their Role in Meeting Women’s Health Care Needs

Health Reform GPS, Essential Community Providers

National Association of Insurance Commissioners, Plan Management Function: Network Adequacy White Paper

National Association for State Health Policy, Potential Roles for Safety Net Providers in Supporting Continuity Across Medicaid and Health Insurance Exchanges

National Association for State Health Policy, How CHIP Can Help Meet Child Specific Requirements and Needs in the Exchange: Considerations for Policymakers

RAND Corporation, Nurse Practitioners and Sexual and Reproductive Health Services: An Analysis of Supply and Demand