The Affordable Care Act has engendered significant changes in the design of health insurance products. We examine the “narrowness” of hospital networks affiliated with plans offered in the first year of the marketplaces. Using data from Texas, we find limited evidence of a tight link between pricing and a simple measure of network breadth, or a more complex measure of network value derived from a logit model of hospital choice. The state's largest insurer priced its narrow networks at a fairly constant discount relative to its broad networks, notwithstanding significant variation in its broad-narrow gap across geographic markets in Texas.

Abstract We consider whether hospital acquisitions of physicians lead to improved clinical outcomes for medicare patients aged 65 and older. The analysis combines 2005–2012 Medicare fee-for-service and enrollment data with merger and physician affiliation information from the Levin Reports and SK&A, respectively. We determine the effect of acquisitions on several health outcomes: mortality, acute myocardial infarctions, acute circulatory conditions, ischemic heart disease, glaucoma, symptomatic diabetes complications, and asymptomatic diabetes complications. These outcomes represent the progression of hypertension and diabetes into worse health states. Our results indicate that hospital acquisitions of existing physician practices have little effect on the health outcomes we consider.