Commercial health insurance highly concentrated in most markets, but not Chattanooga, study shows


Competitors and selections amongst medical health insurance plans have lessened previously 5 years in most U.S. cities, however not in Chattanooga, in response to a brand new research of well being care choices by the American Medical Affiliation.

In its annual evaluation of economic medical health insurance choices, the AMA stated almost three fourths of all metro markets have what federal regulators regard as a extremely concentrated market the place one or two well being insurers dominate the industrial marketplace for well being care protection.

Between 2014 and 2019, the share of markets that had been extremely concentrated in industrial medical health insurance elevated from 71% to 74%. The outcomes had been based mostly upon utilizing the Herfindahl-Hirschman Index (HHI) of market focus typically utilized in anti-trust actions.

“For most of the 70 million People who stay in extremely concentrated medical health insurance markets, an absence of competitors is an issue that retains getting worse as shoppers have extra restricted medical health insurance choices to decide on,” stated AMA President Susan R. Bailey. “The AMA strongly encourages dialogue amongst regulators, policymakers, lawmakers, and others in regards to the want for a greater, extra open and aggressive market to learn sufferers and the physicians who look after them.”

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In Tennessee, the industrial insurance coverage market is considered extremely concentrated with BlueCross BlueShield of Tennessee controlling 52% of the industrial medical health insurance market and Cigna offering one other 30% of the market.

Alabama is the least aggressive market within the nation of all states, the AMA research discovered. Alabama’s Blue Cross and Blue Protect firm dominates the market with an 86% market share,

The market is much less concentrated in Georgia with Anthem, which operates Blue Cross plans in Georgia, having 34% of the market and Aetna having one other 30%.

Though Chattanooga is dwelling to the most important well being insurer in Tennessee, BlueCross BlueShield of Tennessee, the Chattanooga market was among the many one fourth of U.S. cities and not using a “extremely concentrated” marketplace for medical health insurance in 2019. The AMA research confirmed that BlueCross had 40% of the market in 2019, down from 44% the earlier yr, and Cigna had a 19% market share of the enterprise, down from 26% the earlier yr. Chattanooga’s HHI rating of 2457 was just under the 2500 mark for being thought-about extremely concentrated.

Among the many 10 main markets in Tennessee included within the AMA research, solely Chattanooga and Clarksville weren’t thought-about extremely concentrated.

Most concentrated insurance coverage markets

Most concentrated insurance coverage markets” align=”left”>

1. Alabama – Blue Cross has 86% of the market

2. Hawaii – Blue Cross has 66% of the market

3. Michigan – Blue Cross has 67% of the market

4. Delaware – Highmarket has 64% of the market

5. South Carolina – BlueCross has 64% of the market

Supply: American Medical Affiliation

The medical health insurance market is extremely concentrated, nonetheless, in Cleveland, Tennessee the place 51% of the industrial medical health insurance is bought by BlueCross and one other 25% is purchased from Cigna. In Dalton, Georgia, Anthem, which operates Blue Cross plans in Georgia, has a 39% market share and Cigna has 35% of the industrial insurance coverage market.

In a 67-page evaluation of medical health insurance markets launched this week, Jose Guardado, senior economist for the AMA’s Financial and Well being Coverage Analysis division, stated extremely concentrated markets reduce competitors and permit insurers to be in a stronger place to boost premiums for shoppers and reduce funds to suppliers.

“When an insurer workout routines market energy in its output market (the sale of insurance coverage protection), premiums are greater than in a aggressive market,” Guardado writes. “When an insurer workout routines market energy in its enter market (e.g. doctor companies), funds to well being care suppliers are beneath aggressive ranges.”

Contact Dave Flessner at dflessner@timesfreepress.com or at 757-6340



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