降低医疗保险优势保险商集中度与市场结果的微小改善有关,2013-23
1Bowen Garrett (bgarrett@urban.org), Urban Institute, Washington, D.C.
Health affairs (Project Hope)
|October 6, 2025
概括
医疗保险优势 (MA) 市场度下降,但仍然很高. 较低的度与受益人的成本降低等适度的好处有关,但显著的改善需要进一步降低.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健服务研究 医疗服务研究
- 保险市场分析 保险市场分析
背景情况:
- 医疗保险优势 (MA) 注册人数急剧增加,为受益人提供了众多计划选择.
- 尽管选择增加了,但MA市场仍由少数大型保险公司主导,这表明其高度集中.
研究的目的:
- 分析2013-2023年MA保险公司集中度的趋势.
- 检查保险商集中和MA支付,保费,折扣和成本共享之间的关系.
主要方法:
- 使用的医疗保险优势行政数据为2013-2023年期间.
- 使用赫芬达尔-希尔施曼指数 (HHI) 和每个县的保险公司数量来评估市场度.
- 量化了集中变化与财务/计划特征之间的关联.
主要成果:
- 观察到MA保险商度显著下降,尽管总体度仍然很高.
- 减少度与较低的医疗保险支付,较低的个人保险费,增加的计划折扣和更少的注册者成本共享相关.
- 这些效应的规模在量上很小.
结论:
- 虽然MA市场的度下降趋势明显,但目前的水平仍然表明市场度很高.
- 进一步降低MA保险商度不太可能给医疗保险受益者或该计划带来实质性的好处,除非度明显下降到目前水平以下.
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