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Competition in Health Insurance: A Comprehensive Study of U.S. Markets, 2015 Update


Softbound,  8½" x 11",  56 pages
ISBN#: 978-1-62202-392-9 
Item#: OP427115
Authors: American Medical Association

Competition in Health Insurance: A Comprehensive Study of U.S. Markets, 2015 Update

List Price: 150.0
AMA Member: FREE

Available

This title helps researchers, policymakers and federal and state regulators identify areas where consolidation among health insurers may cause anticompetitive harm to consumers and providers of care.

Data on competition in health insurance markets

The 2015 update to the “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 anticompetitive 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 anticompetitive effects of horizontal mergers between firms.

Using 2013 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)—we report the two largest insurers’ commercial market shares and concentration measures (HHIs) for 388 metropolitan areas, the 50 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 our 2012–2014 updates. As a result, this year's competition numbers are directly comparable with the estimates from the previous three previous updates.

Based on the DOJ/FTC Horizontal Merger Guidelines, 70 percent of the 388 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.

The 2015 update of the “Competition in health insurance: A comprehensive study of U.S. markets” is authored by the American Medical Association Division of Economic and Health Policy Research:

David W. Emmons, PhD
Director, Economic and Health Policy Research

José R. Guardado, PhD
Senior economist, Economic and Health Policy Research

Carol K. Kane, PhD
Senior economist II, Economic and Health Policy Research

 

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