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...

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Published in:Health Services Research Vol. 49; no. 3; pp. 878 - 893
Main Authors: McKellar, Michael R, Naimer, Sivia, Landrum, Mary B, Gibson, Teresa B, Chandra, Amitabh, Chernew, Michael
Format: research Journal Article
Published: Wiley-Blackwell Jun2014
Online Access:View this record in EBSCOhost
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      dt: Jun2014
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/1475-6773.12131
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        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
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        research
        Journal Article
      ougenre: Article
    language: English
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