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The 2011 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 368 metropolitan areas and 48 states. It is intended to help researchers, policymakers and federal regulators identify areas where consolidation among health insurers may harm 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.
Noteworthy changes from previous years:
Now includes enrollments in self-insured HMO plans
Classifies the degree of market concentration using federal Horizontal Merger Guidelines issued in August 2010 (which raised the thresholds for classifying markets as concentrated, so fewer markets will now be considered concentrated than under the old guidelines)
Under the new guidelines, 83 percent of 368 metropolitan areas are highly concentrated (HHI>2,500). Moreover, in 95 percent of the metropolitan areas, one or more insurers had a combined HMO+PPO market share of 30 percent or more, and in 47 percent of the areas, at least one insurer had a share of at least 50 percent.
Competition in Health Insurance: A Comprehensive Study of U.S. Markets 2011 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