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The latest AMA Study of Health Insurance Competition reveals that 95% of U.S. metro areas have highly concentrated insurance markets, with single insurers dominating in many regions.

Blue Cross Blue Shield, UnitedHealth Group, and Centene lead the pack, influencing access, pricing, and innovation. It’s a clear call for policies that promote balance and competition.

Check out all of our Madaket Minute’s (link to https://www.madakethealth.com/category/madaket-minute) for more insights.

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MadMin: Dec 2 – AMA Study of Healthcare Insurance Competition in US Markets

The AMA just released its 2024 study of health insurance competition in US markets and found that 95% of U.S. metropolitan areas have highly concentrated commercial health insurance markets- and it’s continued to be this concentrated over the last decade.

AMA President Bruce Scott emphasized the detrimental effect of this concentration on consumer choice and called for action to increase market competition.

In about half of the metro areas, a single insurer owned at least 50% of the market.

Blue Cross Blue Shield was the most dominant insurer in 83% of metro areas, while Elevance Health had the highest market share in 21% of these regions.

Meanwhile, UnitedHealth Group was the largest healthcare payer in terms of national market share, while Centene dominated the largest portion of the Affordable Care Act’s exchange markets.

The study illustrates the persistent dominance of just a few insurers in both commercial and Medicare Advantage insurance markets, highlighting a critical need for regulatory and policy interventions to foster a more competitive landscape for employers and Medicare patients.

Source: https://www.ama-assn.org/system/files/competition-health-insurance-us-markets.pdf

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