A large number of providers in a network does not make a network good.
Few providers and a handful of hospitals does not make a network bad.
A good network has a sufficient number of providers in a wide variety specialties so that members can quickly get appropriate and high quality care at locations that are reasonably close to the member and in a reasonably short time period. In my region, a good network could have 10 hospitals and 900 MD/DO providers in it. I would be happy buying that coverage for my family. A really bad network could have 25 hospitals in it and 3,500 MD/DOs and I would pay significant sums to avoid that product.
Most of the APTC hacking that I’ve been working on has been manipulations of the cost sharing elements of plan design. Those are the easiest elements to do as any idiot can run tweaks through the actuarial value calculator and come up with “unique” isomorphic clones to capture the low price Silver region. Manipulating networks takes a little more time and forethought but it could be done as another APTC hack.
There are a couple of different ways to create strategically bad networks.
Here is how it works.