Insurer Market Power Lowers Prices In Numerous Concentrated Markets.

Using prices of hospital admissions and visits to five types of physicians, we analyzed how provider and insurer market concentration--as measured by the Herfindahl-Hirschman Index (HHI)--interact and are correlated with prices. We found evidence that in the range of the Department of Justice's and...

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Publicado en:Health Affairs Vol. 36; no. 9; pp. 1539 - 1547
Autores principales: Scheffler, Richard M., Arnold, Daniel R.
Formato: research tables/charts Journal Article
Publicado: Health Affairs Publishing, LLC Sep2017
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Insurer Market Power Lowers Prices In Numerous Concentrated Markets.
      aug:
        au:
          Scheffler, Richard M.
          Arnold, Daniel R.
        affil: Distinguished professor of health economics and public policy at the School of Public Health, at the University of California, Berkeley
      sug:
        subj:
          Insurance, Health
          Insurance Carriers
          Economic Competition
          Health Insurance Exchanges
          Human
          Government Agencies
          Comparative Studies
          Primary Health Care
          Physicians
          Variable
          Hospitals
          Health Care Costs
          Insurance, Health, Reimbursement
          Preferred Provider Organizations
          Surveys
          Linear Regression
          Current Procedural Terminology
          Funding Source
      ab: Using prices of hospital admissions and visits to five types of physicians, we analyzed how provider and insurer market concentration--as measured by the Herfindahl-Hirschman Index (HHI)--interact and are correlated with prices. We found evidence that in the range of the Department of Justice's and Federal Trade Commission's definition of a moderately concentrated market (HHI of 1,500-2,500), insurers have the bargaining power to reduce provider prices in highly concentrated provider markets. In particular, hospital admission prices were 5 percent lower and cardiologist, radiologist, and hematologist/oncologist visit prices were 4 percent, 7 percent, and 19 percent lower, respectively, in markets with high provider concentration and insurer HHI above 2,000, compared to such markets with insurer HHI below 2,000. We did not find evidence that high insurer concentration reduced visit prices for primary care physicians or orthopedists, however. The policy dilemma that arises from our findings is that there are no insurer market mechanisms that will pass a portion of these price reductions on to consumers in the form of lower premiums. Large purchasers of health insurance such as state and federal governments, as well as the use of regulatory approaches, could provide a solution.
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      ougenre: Article
    language: English
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