医疗保险优势:国家运营商扩大市场份额,而非附属区域运营商下降,2012年至23年
Joseph G P Hnath1, J Michael McWilliams2, Michael E Chernew3
1Joseph G. P. Hnath (josephhnath@g.harvard.edu), Harvard University, Cambridge, Massachusetts.
Health affairs (Project Hope)
|December 3, 2024
概括
医疗保险优势 (MA) 市场显示了国家保险公司集中度的增加,国家运营商获得了相当大的市场份额. 当地市场竞争已经下降,这表明在假设市场竞争力的情况下,政策改革面临潜在挑战.
科学领域:
- 卫生政策 卫生政策
- 市场分析市场分析
- 保险经济学 保险经济学
背景情况:
- 医疗保险优势 (MA) 计划是美国老年人医疗保健的关键组成部分.
- 了解MA市场内的保险商竞争对于评估计划有效性和政策影响至关重要.
- 市场度趋势可以影响计划选择,成本和受益人的护理质量.
研究的目的:
- 分析医疗保险优势市场不断变化的竞争格局.
- 在保险商集中方面,区分国家和地方市场动态.
- 通过评估MA市场的竞争力,为政策决策提供信息.
主要方法:
- 利用来自医疗保险和医疗补助服务中心 (CMS) 的数据.
- 从2012年到2023年检查了医疗保险优势保险公司的国家和地方市场份额趋势.
- 分析了市场集中度和医疗保险优势透率之间的关系.
主要成果:
- 国家市场度显著增加,国家运营商的份额在2012年至2023年间从46%上升到66%.
- 由于收购,非蓝色区域航空公司的市场份额大幅下降.
- 当地市场度有所下降,但仍然很高,预计会进一步下降,特别是在透率高的市场.
结论:
- 医疗保险优势市场正变得越来越集中在国家,由国家运营商之间的整合驱动.
- 当地市场竞争不如国家趋势所显示的那么有活力,如果没有有针对性的干预措施,可能无法改善.
- 假设MA市场竞争力的政策改革如果不积极解决市场集中问题,可能会失败.
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