Health Insurance Industry Market Structure

Health Insurance Industry Market Structure

Author: Brent C. Jenner

Publisher: Nova Science Publishers

Published: 2010

Total Pages: 0

ISBN-13: 9781617612893

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This book discusses how the current health insurance market structure affects the two policy goals of expanding health insurance coverage and containing health care costs. Concerns about concentration in health insurance markets are linked to wider concerns about the cost, quality, and availability of health care. The market structure of the health insurance and hospital industries may have contributed to rising health care costs and deteriorating access to affordable health insurance and health care. Many features of the health insurance market and the ways it links to other parts of the health care system can hinder competition, lead to concentrated markets, and produce inefficient outcomes.


Health Insurance Market Structure and State-Based Public Option Laws

Health Insurance Market Structure and State-Based Public Option Laws

Author: Gerardo Ruiz Sanchez

Publisher:

Published: 2022

Total Pages: 0

ISBN-13:

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In response to political gridlock at the federal level and concerns about market concentration in the private health insurance industry, several U.S. states have proposed their own bills to establish state-based public option programs, including three that recently became law in Washington State, Colorado, and Nevada. I study Washington State's Cascade Care Law, which implemented a state-based public option program in its individual health insurance market starting in 2021. I use plan offering data and administrative enrollment data from the Washington Health Benefit Exchange, Washington's state-based Affordable Care Act exchange, to provide a descriptive analysis of how market structure, insurers' plan offering decisions, individual enrollment, and market concentration evolved during the 2020-2022 plan years. A key descriptive finding of this paper is that county-level insurance market competition has improved since Washington's state-based public option program was implemented; with thirteen and twelve insurers offering plans in 2021 and 2022, respectively, up from nine insurers in 2020. I also document considerable variation in the set of plans insurers decided to offer and the set of counties they served. Enrollment in the public option plans that were offered was low.


Size Matters

Size Matters

Author: Jill Mathews Yegain

Publisher: Routledge

Published: 2019-07-23

Total Pages: 263

ISBN-13: 042980024X

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First published in 1999, this volume responds to a large and growing interest among health policy and research circles on the use of purchasing alliances to leverage change in health care. This book gives detailed and useful specifics on how a leading alliance has fared in California, the most competitive health care market in the United States. Although it is generally accepted that large organizations are more effective purchasers of health insurance, little work has been done to carefully examine the reasons that underlie that phenomenon. Yet, creating interventions and designing potential solutions requires a thorough understanding of the issues. The econometric analysis adds to the limited literature on the influence of premium on choice behaviour for employees of small firms, and introduces an analysis of choice behaviour in a purchasing cooperative setting. The political section of this book presents a much more detailed historical account and analysis of California’s small group market reforms, the most significant health-related legislation in the state in the prior decade, than has been previously available. The conclusions are becoming particularly relevant, both in California and elsewhere, as the issues of reform of the individual market for health insurance comes to the forefront.


Private Health Insurance

Private Health Insurance

Author: John E. Dicken

Publisher: DIANE Publishing

Published: 2010-06

Total Pages: 13

ISBN-13: 1437921493

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Consolidation in the private health insurance (PHI) industry may be resulting in less competitive markets and contributing to rising health insurance rates paid by consumers and employers. However, measuring the extent of changes in market competition over time or the effects of changes is challenging. Researchers have used the data available to study competition in PHI markets, typically using one of two measures of competition: HMO market concentration; or the number of HMOs in a market. This report summarizes the findings of peer-reviewed research on concentration in PHI markets and the relationship between the level of competition and other variables, such as premium prices and provider reimbursement rates. Illustrations.


Care Without Coverage

Care Without Coverage

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2002-06-20

Total Pages: 213

ISBN-13: 0309083435

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Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.


Market Structure and the Performance of the U.S. Health Insurance Marketplace

Market Structure and the Performance of the U.S. Health Insurance Marketplace

Author: Cassandra R. Cole

Publisher:

Published: 2014

Total Pages: 0

ISBN-13:

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Health insurance premiums have more than doubled over the last ten years, with some suggesting that this may be the result of the high market concentration in the health insurance industry. In this paper, we conduct a state-level analysis in which we examine the health insurance marketplace, the degree of market concentration, and health insurance costs across states. We generally find that the barrier to entry into health insurance market is relatively low, as witnessed by the increase in the number of insurers operating in most states over the sample period; accordingly, the extent of market concentration has declined in recent years. We also find evidence of a positive relation between market concentration and insurer profits.


The Economics of Property-Casualty Insurance

The Economics of Property-Casualty Insurance

Author: David F. Bradford

Publisher: University of Chicago Press

Published: 2007-12-01

Total Pages: 218

ISBN-13: 0226070328

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The Economics of Property-Casualty Insurance presents new research and findings on key aspects of the economics of the property-casualty insurance industry. The volume explores the industrial organization, regulation, financing, and taxation of this business. The first paper, on external financing and insurance cycles, contains a wealth of information on trends and patterns in the industry's financial structure. The last essay, which compares performance of stock and mutual insurance companies, takes a fresh look at the way a company's organizational structure affects its responses to different economic situations. Two papers focus on rate regulation in the auto insurance industry, and provide broad overviews of the structure and economics of the insurance industry as a whole. Also addressed are the system of regulating insurance companies in the United States, who insures the insurers, and the effects of tax law changes in the 1980s on the prices of insurance policies.


Health-Care Utilization as a Proxy in Disability Determination

Health-Care Utilization as a Proxy in Disability Determination

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2018-04-02

Total Pages: 161

ISBN-13: 030946921X

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The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.