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Balancing patient choice and consumer cost in health plans.

As health insurers in all market segments look for ways to reduce costs, they increasingly are limiting the number of providers within a given health care network. This trend is causing policy makers to look more closely at something called "network adequacy."

Network adequacy refers to a health plan's ability to deliver promised benefits by providing reasonable access to a sufficient number of in-network primary care and specialty physicians, and to all other health care services included under the terms of the contract.

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  1. The Henry J. Kaiser Family Foundation. Kaiser Health Tracking Poll: February 2014. http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-february-2014/. Accessed March 18, 2015.
  2. America's Health Insurance Plans. Milliman Report: High Value Healthcare Provider Networks. July 2014. http://www.ahip.org/Workarea/DownloadAsset.aspx?id=2147497736. Accessed March 18, 2015.

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