Hospital-Medicare Advantage Vertical Consolidation, 1980 to 2024

Health care consolidation continues to increase in the United States. Most of the evidence focuses on horizontal consolidation or vertical consolidation between hospitals and physician practices. The lack of comprehensive and longitudinal data identifying insurer and hospital vertical consolidation has limited study of the prevalence, variations, and impact of this form of consolidation. Therefore, we created a novel dataset of hospital-Medicare Advantage (MA) contract consolidation from 1980 to 2024. We illustrate the power of this novel dataset through analysis of annual trends in hospital-MA contract consolidation and state-level geographic variation in the share of hospitals consolidated with MA contracts. We also show that a quarter of hospital integrated MA contracts are owned by an MA insurer that owns other non-hospital integrated MA contracts. We make this dataset public to facilitate research on hospital-MA contract consolidation that can inform health care policy and anti-trust law.