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Data on competition in health insurance markets
The 2013 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 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 type of information to assess the anti-competitive effects of horizontal mergers between firms.
Using 2011 data from HealthLeaders-Interstudy—the most comprehensive source of data on enrollment in health maintenance organization (HMO), preferred provider organization (PPO), point-of-service (POS) and consumer-driven health plans (CDHP), this update reports commercial market shares and concentration measures (HHIs) for 386 metropolitan areas, the 50 U.S. states and the District of Columbia.
The methodology employed in developing the market shares and concentration estimates for this year's update is the same as that used in the 2012 update. As a result, this year's concentration numbers are directly comparable with the estimates in the 2012 update.
Based on the DOJ/FTC Horizontal Merger Guidelines, 71 percent of the 386 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 41 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 2013 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