Impact of Healthcare Market Concentration in Indiana in the Insurance, Hospital, and Professions of Licensed Healthcare Practitioners Industries

Project Period

October 7, 2021 – October 31, 2022

About the Project

For this project, the Petris Center will use its healthcare markets expertise, technical knowledge, and data library to create a report and presentation that describe the market concentration in the hospital industry, professions of licensed healthcare practitioners (focusing on physicians) industry, and the health insurance industry in each of Indiana’s 15 MSAs based on the first four scope-of-services described in the RFA. For the last two scope-of-services described in the RFA, which are to report and compare the impact of market concentration on prices across MSAs, the Petris Center will make four significant contributions. First, we will estimate the impact of market concentration on not only healthcare prices but also insurance premiums, which is the price consumers pay. Second, we will study the impact of hospital-physician vertical integration–a form of market concentration–which often leads to higher healthcare prices and expenditures without a conclusive impact on quality.22,23 In a study we recently published in Inquiry, we found that hospital-physician vertical integration was associated with price increases for office visits for primary care, orthopedic, and cardiology services.24 Third, the Petris Center will use Vericred Provider Network Files to identify hospitals in Indiana that are so-called “must-have” hospitals and compare prices in these hospitals to other hospitals in the market. Fourth, in a related vein, we will examine whether health systems operating in multiple markets are able to use cross-market ownership leverage–yet another form of market concentration–when negotiating with insurance payers in Indiana because these payers contract with these systems in multiple markets that include must-have hospitals.19 With support from Arnold Ventures and the Commonwealth Fund, the Petris Center is studying the impact of cross-market ownership leverage across the United States. This research will be published in early 2022; hence, it will be able to apply these same methods and data to examine cross-market effects in Indiana.