Covered California: The Impact of Provider and Health Plan Market Power on Premiums.

We explain the establishment of Covered California, California's health insurance marketplace. The marketplace uses an active purchaser model, which means that Covered California can selectively contract with some health plans and exclude others. During the 2014 open-enrollment period, it enrolled 1...

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Publicado en:Journal of Health Politics, Policy & Law Vol. 40; no. 6; pp. 1179 - 1203
Autores principales: Scheffler, Richard M., Kessell, Eric, Brandt, Margareta
Formato: Artículo
Publicado: Duke University Press Dec2015
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2015
      vid: 40
      iid: 6
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      pub: Duke University Press
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        atl: Covered California: The Impact of Provider and Health Plan Market Power on Premiums.
      aug:
        au:
          Scheffler, Richard M.
          Kessell, Eric
          Brandt, Margareta
        affil: University of California, Berkeley
      su:
        California
        Medical care
        Health policy
        Age distribution
        Insurance
        Economics
        Health insurance exchanges
        User charges
        Patient Protection & Affordable Care Act
        State health plans
      sug:
        subj:
          Medical care
          Health policy
          Age distribution
          Insurance
          Economics
          California
          All Other Insurance Related Activities
          Other Insurance Funds
          Third Party Administration of Insurance and Pension Funds
          Administration of Public Health Programs
          Health insurance exchanges
          User charges
          Patient Protection & Affordable Care Act
          State health plans
      keyword:
        Covered California
        health insurance marketplace
        Covered California
        health insurance marketplace
      ab: We explain the establishment of Covered California, California's health insurance marketplace. The marketplace uses an active purchaser model, which means that Covered California can selectively contract with some health plans and exclude others. During the 2014 open-enrollment period, it enrolled 1.3 million people, who are covered by eleven health plans. We describe the market shares of health plans in California and in each of the nineteen rating regions. We examine the empirical relationship between measures of provider market concentration--spanning health plans, hospitals, and medical groups--and rating region premiums. To do this, we analyze premiums for silver and bronze plans for specific age groups. We find both medical group concentration and hospital concentration to be positively associated with premiums, while health plan concentration is not statistically significant. We simulate the impact of reducing hospital concentration to levels that would exist in moderately competitive markets. This produces a predicted overall premium reduction of more than 2 percent. However, in three of the nineteen rating regions, the predicted premium reduction was more than 10 percent. These results suggest the importance of provider market concentration on premiums.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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