Nov 29, 2018

Most insurance markets are highly concentrated

Data: American Medical Association; Cartogram: Lazaro Gamio/Axios

A new study by the American Medical Association found that 73% of metropolitan areas have highly concentrated health insurance markets. One insurer had at least a 50% market share in almost half of the areas.

Between the lines: Insurers with a lot of market power can, in theory, raise premiums and pay providers less. But this study isn't proof that insurers in concentrated areas are doing that.

It does, however, cite other research finding that insurer consolidation has correlated with higher premiums.

  • Provider consolidation is another huge market trend to watch, and one study has found that insurers with more market power can drive lower prices in highly concentrated provider markets.

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Surprise medical bills inflate everyone's health insurance premiums

Data: Health Affairs; Chart: Axios Visuals

Four specialties that are often out-of-network — anesthesiologists, pathologists, radiologists and assistant surgeons — raise employer insurance spending by 3.4%, according to a new study in Health Affairs.

Why it matters: Surprise medical bills are not only unaffordable for the patients who receive them, but also inflate everyone else's premiums.

Go deeperArrowDec 17, 2019

Hospital charges surge over last 2 decades, especially in the ER

Reproduced from Thomas M. Selden, 2019, "Differences Between Public and Private Hospital Payment Rates Narrowed"; Chart: Axios Visuals

The rates charged by hospitals — especially for emergency department care — have skyrocketed over the last two decades, according to a new study in Health Affairs.

Why it matters: While most patients with insurance don't pay these prices for their care — insurers typically negotiate lower rates — those who are uninsured or out-of-network often do.

Go deeperArrowJan 7, 2020

Many Americans still can't afford medical expenses

Reproduced from Gallup; Note: ±4 percentage point margin of error; Chart: Axios Visuals

The latest poll from Gallup shows more Americans are putting off medical care because of the cost.

Why it matters: Despite a declining unemployment rate and growing GDP, an increasing number of Americans say they are forgoing often necessary medical procedures because of the cost.

Go deeperArrowJan 15, 2020