Becker's Hospital Review

54 FINANCE AMA: Insurer Mergers Would Hurt Competition in 154 Metro Areas By Molly Gamble D ata released by the American Medical Association suggests the proposed Anthem-Cigna and Aetna-Humana mergers could lessen competition in up to 154 metropolitan areas across 23 states. Individually, the AMA says the Anthem- Cigna deal could reduce competition in up to 111 metropolitan areas in all 14 states Anthem currently operates, while the Aetna-Humana merger would lessen competition in up to 58 metro areas across 14 states. e AMA said the prospect of five national health insurance carriers shrinking to three "should be viewed in the context of the unprecedented lack of competition that already exists in most health insurance markets." e analysis found 14 states had a single health insurer with at least 50 percent share of the commercial health insurance market, while 46 states had two insurers with at least 50 percent share of the commercial market. e AMA has analyzed insurance competition for 15 years. e latest edition of its report studies competition in 388 metro areas as well as all states and Washington, D.C., based on 2013 data. AMA President Steven J. Stack, MD, said the association is urging federal and state regulators to review the proposed deals and use enforcement tools to preserve competition. "A lack of competition in health insurer markets is not in the best interests of patients or physicians," Dr. Stack said in a statement. "If a health insurer merger is likely to erode competition, employers and patients may be charged higher than competitive premiums, and physicians may be pressured to accept unfair terms that undermine their role as patient advocates and their ability to provide high-quality care. n 10 States With Least Competitive Commercial Health Insurance Markets By Molly Gamble H ere are the states, listed in order of least competitive, with little competition among commercial health insurers. The American Medical Association based rankings on market concentration levels as determined by the Herfindahl–Hirschman Index, a measure used by the U.S. Department of Justice and the Federal Trade Commission. commercial health insurance markets HMO markets PPO markets POS markets 10 states with largest drop in competition levels 10 states with least competitive... 1 10 1 10 1 10 1 10 1 10 Alabama Vermont South Carolina Utah Louisiana Nebraska North Dakota Nevada Idaho Colorado Alabama Hawaii Michigan Delaware Alaska South Carolina Louisiana Nebraska Illinois North Dakota Alabama South Carolina Michigan Iowa Louisiana North Carolina Delaware Nebraska Tennessee Hawaii Rhode Island Oklahoma Nebraska Montana New Mexico Iowa Alabama Alaska Mississippi Arizona Louisiana Idaho New Jersey Missouri Montana Illinois Texas West Virginia Iowa Ohio

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