PPO plans on the Affordable Care Act marketplace declined significantly from 2015 to 2016, with 28 percent dropped and 39 percent reduced, according to a report from Robert Wood Johnson Foundation.
During the marketplaces' first two years, a wide range of plan choices were available on the exchanges. For instance, roughly 35 percent of silver plans offered in 2014 were PPOs. Although the number of silver plans nearly doubled in 2015, the rate of PPOs remained relatively steady at 39 percent of all marketplace plans. Now, PPOs seem to be fading from the exchanges.
Here are six key findings from the report.
1. In the months leading up to the start of the 2016 open enrollment period, several high-profile insurers announced the withdrawal of their PPO plans from the ACA marketplace, including BCBS of Texas, BCBS of New Mexico and BCBS of Illinois. Assurant and Community Health Alliance offered the most unique PPO plans in the most states, but they dropped all of their PPO offerings because they exited the market.
2. In 2015, 93 different carriers offered 790 unique PPO plans in 48 states, according to the report. Since many carriers offered PPO plans in multiple states, there were a total of 131 unique carrier-state PPO plans available. A median of four PPO plans were offered by a carrier in a state.
3. Only 33 percent of PPO offerings on the exchanges remained the same from 2015 to 2016, with 28 percent dropped and 39 percent reduced. According to the report, dropped PPO plans were the result of carriers exiting the marketplace or because they discontinued their PPO offerings. Reductions of PPO plans on the exchanges resulted from carriers reducing the number of plans they offered or limiting plan offerings to fewer rating areas.
4. In 22 states, all PPO plans offered on the exchanges were either dropped or reduced between 2015 and 2016. PPO offerings remained unchanged in 11 states, and the rest of the states fell somewhere in between. (Robert Wood Johnson Foundation did not include New Jersey and New York in their analysis of PPO plan offerings by state because there were no PPO plans available in these states in 2015.)
5. PPO plan changes followed a regional pattern, according to the report. PPO offerings were more likely to be dropped in 2016 in the Mountain or West South Central regions and less likely to be dropped in the Pacific and Northeast regions.
6. Carriers who discontinued PPOs said they have done so because high expenses make it impossible to afford price exchange products.