Academic Medicine Open Forum

A new data snapshot from the AAMC Research and Action Institute demonstrates the relative market concentration among #healthcare providers and insurers. Across all U.S. states, the largest health systems by total inpatient hospital discharges account for just 20% of the market on average, while the largest health insurers account for 50% of the large-group market. In any given state, the three or four largest health systems combined have an average of 43.1% of the total market share, while the top three large-group insurers hold an average of 82.2% of the market share.  

Insurer consolidation can lead to higher premiums for patients and lower rates paid to providers, which can result in detrimental effects for health systems including discontinued specialized services, hospital closures, and other cuts. Regulators and courts concerned about consolidation must consider all sides of the market for health care goods and services, including the impact of both insurer and provider consolidation on payment rates, patient access, out-of-pocket costs, and quality of care.

I welcome your advice and insight. What do you think about the role of market power in the U.S. health care system? Is it possible for small practices to survive/negotiate with insurers that control over half of the private market? 

Read the full snapshot at Why Market Power Matters for Patients, Insurers, and Hospitals