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Dr. Brent Fulton’s new paper “Health Care Market Concentration Trends In The United States: Evidence And Policy Responses” was published in Health Affairs this week. Dr. Fulton’s study analyzes market concentration trends in the United States from 2010 to 2016 for hospitals, physician organizations, and health insurers, finding that hospital and physician organization markets became increasingly concentrated over this time period. Concentration among primary care physicians increased the most, partially because hospitals and health care systems acquired primary care physician organizations. The paper finds that a large number of Metropolitan Statistical Areas (MSAs) are highly concentrated – in 2016, reaching 91% for hospitals, 65% for specialist physicians, 39% for primary care physicians, and 57% for insurers. The paper concludes that public policies that enhance competition are needed, such as stricter enforcement of antitrust laws, reducing barriers to entry, and restricting anticompetitive behaviors.
The September issue of Health Affairs features a collection of papers addressing health care market concentration. Earlier versions of these articles were presented at the “Impact of Healthcare Market Concentration on Healthcare Prices and Premiums: What Can and Should Be Done” conference, organized by the Petris Center, at the Robert F. Wagner Graduate School of Public Service, New York University, New York City, on April 14, 2017.