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Data on competition in health insurance markets
The 2012 update to Competition in Health Insurance: A Comprehensive Study of U.S. Markets
presents new data on the level of competition in health insurance markets across the United States.
It reports commercial market shares and concentration measures (HHIs) for 385 metropolitan areas, the 50 U.S. states and the District of Columbia. It is intended to help researchers, policymakers and federal and state regulators identify areas where consolidation among health insurers may cause anti-competitive harm to consumers and providers of care. The Department of Justice (DOJ) and Federal Trade Commission (FTC) use this information to assess the anti-competitive effects of horizontal mergers.
Based on the DOJ/FTC Horizontal Merger Guidelines, 70 percent of 385 metropolitan areas are highly concentrated (HHI>2,500). Additionally, in 89 percent of the metropolitan areas, one or more insurers had a combined HMO+PPO+POS market share of 30 percent or more, and in 38 percent of the areas, at least one insurer had a share of at least 50 percent.
Noteworthy changes from previous years:
- Includes enrollments in Point-of-Service (POS) plans
- Includes participation in Consumer-Driven Health Plans (CDHP)
Competition in Health Insurance: A Comprehensive Study of U.S. Markets 2012 Update is authored by the American Medical Association Division of Economic and Health Policy Research:
David W. Emmons, PhD
Director, Economic and Health Policy Research
Jose R. Guardado, PhD
Economist, Economic and Health Policy Research
Carol K. Kane, PhD
Senior Economist II, Economic and Health Policy Research