How does network adequacy affect member access to care?

• A. Increases out-of-network costs.
• B. Eliminates the need for referrals.
• C. Ensures sufficient in-network providers and reasonable travel times for members.
• D. Increases administrative burden only.

Answer: (C)

Network adequacy means having enough in-network providers distributed across the plan’s area so members can get care without long travel or long waits. When the network is adequate, members can find primary care and specialty care nearby and schedule timely appointments, making access to care easier and more predictable. This reduces the need to seek care outside the network and helps keep costs more stable since services are covered at in-network levels.

So, the best description is that it ensures there are sufficient in-network providers and reasonable travel times for members. The other options describes outcomes or plan features that aren’t the defining aim of network adequacy: higher out-of-network costs would come from an inadequate network, referrals depend on plan design, and administrative burden isn’t the core focus of adequacy.