Unwieldy networks

There is a Wall Street Journal article that has been making the rounds on the internet last week. The article cites a few cases where payers (whether large self-insured employers or insurance companies) tried to exclude certain individual providers from some plans and were stymied by the terms of seemingly unrelated contracts. For example, Walmart ask to remove the 5% of providers with the worse quality scores from its networks, and found that it was unable to do so. The article attributes the inability for payers to selectively modify specific networks to the market dominance that health systems often enjoy, allowing them to force clauses that prohibit such modifications. As long as the payers contract with those health systems (and the payers often cannot avoid doing so), the payers are obligated to include all individual clinicians in all plans.

Interestingly, the providers will frame this as consumer choice, saying that patients should have access to the full range of providers within a health system. What that response omits is what happens if patients want to achieve lower monthly premiums by having a restricted network? Where is patient choice in that case?