Consolidation in Payer, Provider Markets Continues to Rise

About 73% of health insurance markets in the metropolitan statistical areas were highly concentrated in 2020, while in 46% of those markets, a single insurer’s market share reached at least 50%, according to the 2021 edition of an annual report from the American Medical Association. The consolidation trend is also pronounced with providers, a trend that is likely to be accelerated due to revenue shortfalls caused by the pandemic. A Health Affairs study found that the share of primary care physicians affiliated with vertically integrated health systems increased from 38% in 2016 to 49% in 2018, while more than half of physicians and 72% of hospitals were affiliated with one of 637 health systems in 2018. Yet several studies suggested that there is no clear evidence that provider consolidation leads to higher quality of care.

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Jinghong Chen

Jinghong Chen Reporter

Jinghong has been producing infographics and data stories on employer-sponsored insurance, public health insurance programs and prescription drug coverage for AIS Health’s Health Plan Weekly and Radar on Drug Benefits since 2018. She also manages AIS Health’s annual executive compensation database for top insurers and Blue Cross and Blue Shield affiliates. Before joining AIS Health, she interned at WBEZ, Al Jazeera English and The New York Times Chinese. She graduated from Missouri School of Journalism with a focus on data journalism and international reporting.

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