Insurer market structure and variation in commercial health care spending.
Objective: To examine the relationship between insurance market structure and health care prices, utilization, and spending.Data Sources: Claims for 37.6 million privately insured employees and their dependents from the Truven Health Market Scan Database in 2009. Measures of insurer market structure...
| Published in: | Health Services Research Vol. 49; no. 3; pp. 878 - 893 |
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| Main Authors: | , , , , , |
| Format: | research Journal Article |
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Wiley-Blackwell
Jun2014
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103943444&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103943444 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00179124 HSR jtl: Health Services Research issn: 00179124 maglogo: Y pubinfo: dt: Jun2014 vid: 49 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 103943444 NLM24303879 2012583464 10.1111/1475-6773.12131 NLM24303879 103943444 ppf: 878 ppct: 15 formats: tig: atl: Insurer market structure and variation in commercial health care spending. aug: au: McKellar, Michael R Naimer, Sivia Landrum, Mary B Gibson, Teresa B Chandra, Amitabh Chernew, Michael affil: Department of Health Care Policy, Harvard Medical School, Boston, MA. sug: subj: Business Economics Health Care Costs Health Insurance Exchanges Economics Health Insurance Exchanges Administration Human United States ab: Objective: To examine the relationship between insurance market structure and health care prices, utilization, and spending.Data Sources: Claims for 37.6 million privately insured employees and their dependents from the Truven Health Market Scan Database in 2009. Measures of insurer market structure derived from Health Leaders Inter study data.Methods: Regression models are used to estimate the association between insurance market concentration and health care spending, utilization, and price, adjusting for differences in patient characteristics and other market-level traits.Results: Insurance market concentration is inversely related to prices and spending, but positively related to utilization. Our results imply that, after adjusting for input price differences, a market with two equal size insurers is associated with 3.9 percent lower medical care spending per capita (p = .002) and 5.0 percent lower prices for health care services relative to one with three equal size insurers (p < .001).Conclusion: Greater fragmentation in the insurance market might lead to higher prices and higher spending for care, suggesting some of the gains from insurer competition may be absorbed by higher prices for health care. Greater attention to prices and utilization in the provider market may need to accompany procompetitive insurance market strategies. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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