Impact of Health Care Market Concentration on Insurance Premiums: Evidence from the Health Insurance Marketplaces, Phase 2

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The consolidation of health care markets and insurers across the nation raises a number of concerns, including the potential impact on premiums. This project will examine the effect of consolidation on the provider side of the market by considering the perspective of insurers, hospitals, and physician organizations. Based on findings from the first phase, the research team published two articles in Health Affairs, along with accompanying op-eds in the New York Times on health care market concentration trends since enactment of the ACA. Building on this work, the proposed grant will quantify the impact of health care market concentration on insurance premiums and health care prices. The project team will use a variety of data sets to quantify the impact of market concentration on prices and premiums. Key data sources will include: the Robert Wood Johnson Foundation–Health Insurance Exchange Compare premium data for 2014–2017, supplemented with Fund grantee Jon Gabel's premium database; the National Association of Insurance Commissioners' Health InfoPro data for the 2010–2016 individual and group market; the Health Care Cost Institute's claims database for 2010–2014; 2010–2016 health care market concentration data from the American Hospital Association's Annual Hospital Survey; SK&A's office-based physicians database provided by IMS Health; and the HealthLeaders–Interstudy managed market survey of health insurers. Findings will inform policymakers about the impact of increased health care market concentration, including the potential harm or benefit to consumers and insurers. This research will inform those involved with antitrust enforcement and the debate regarding future mergers and acquisitions.

Grant Details

Grantee Organization:
Regents of the University of California at Berkeley
Principal Investigator:
Richard Scheffler, Ph.D.
Award Amount:
$198,356.00
Approval Date:
April 11, 2017

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