This week I’d like us to consider the new Health Insurance Marketplace in New Hampshire. You may have heard that only one insurer decided to participate and so, for now, the marketplace is limited in carriers and the one carrier has a limited network. Anthem will have 11 lines and will release details of the plans later this week, sharing representative examples of the rates people will pay.

From the physician’s perspective, competition in the insurance marketplace will be a good thing for consumers. The marketplace, however, doesn’t seem to increase competition – at least not this year. Still, I hope we will choose to look at the current situation of a limited network in a limited marketplace as a first step in an immature market. I believe it will take at least several years to see if the marketplace will be successful. Harvard Pilgrim has expressed intent to join the marketplace next year with the Dartmouth-Elliot insurance product Elevate-Health, which currently has an even more limited network. I predict others will follow in joining the marketplace over the next few years. As well, we are awaiting news of whether a multi-state plan will be offered in New Hampshire in 2014 (two multi-state plans must be in each marketplace by 2017).

The challenge for us will be how to navigate the landscape of limited networks. Over the past 10 years insurance networks in New Hampshire have been fairly open and this shift toward limited markets will certainly affect our practices and the choices our patients have. I’d be interested to hear your thoughts on the marketplace and the impact of limited networks on your practice to see if there is a role for NHMS to support you as these changes take effect.

Please send your questions or comments to or post a comment below.


Hi Travis, I am going to be strongly affected by the Anthem limited network as they are anticipating that the Anthem will continue to limit the networks for their employer sponsored plans as well. this will effectively remove highly performing physicians from being able to work in NH. I realize that I may be over-reacting but am very concerned about the impact on limited choice for patients and the effect on the patient doctor relationship. I have several patients who will have to change doctors after up to 14 years as their doctor. I just don't get it. Insurance profits should not take first seat. If the medical society could intervene with the insurance commissioner and the governor to get the networks broadened this would help. Thanks, Deb Harrigan