Differing Impacts Of Market Concentration On Affordable Care Act Marketplace Premiums

被引：20

作者：

Scheffler, Richard M. ^{[1
,2
,3
]}

Arnold, Daniel R. ^{[4
,5
]}

Fulton, Brent D. ^{[3
]}

Glied, Sherry A. ^{[6
]}

机构：

[1] Univ Calif Berkeley, Sch Publ Hlth, Berkeley, CA 94720 USA

[2] Univ Calif Berkeley, Rhoda Goldman Sch Publ Policy, Berkeley, CA 94720 USA

[3] Univ Calif Berkeley, Nicholas C Petris Ctr Hlth Care Markets & Consume, Sch Publ Hlth, Berkeley, CA 94720 USA

[4] Univ Calif Berkeley, Berkeley, CA 94720 USA

[5] Univ Calif Santa Barbara, Econ, Santa Barbara, CA 93106 USA

[6] NYU, Robert F Wagner Grad Sch Publ Serv, Publ Serv, New York, NY 10003 USA

来源：

HEALTH AFFAIRS | 2016年 / 35卷 / 05期

关键词：

HOSPITAL PRICES; POWER;

D O I：

10.1377/hlthaff.2015.1229

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Recent increases in market concentration among health plans, hospitals, and medical groups raise questions about what impact such mergers are having on costs to consumers. We examined the impact of market concentration on the growth of health insurance premiums between 2014 and 2015 in two Affordable Care Act state-based Marketplaces: Covered California and NY State of Health. We measured health plan, hospital, and medical group market concentration using the well-known Herfindahl-Hirschman Index (HHI) and used a multivariate regression model to relate these measures to premium growth. Both states exhibited a positive association between hospital concentration and premium growth and a positive (but not statistically significant) association between medical group concentration and premium growth. Our results for health plan concentration differed between the two states: It was positively associated with premium growth in New York but negatively associated with premium growth in California. The health plan concentration finding in Covered California may be the result of its selectively contracting with health plans.

引用

页码：880 / 888

页数：9

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