New Evidence about the Heterogeneity of Indiana’s Healthcare Markets: Competition, Costs, and the Impacts of Market Structure

By Brent D. Fulton, Daniel R. Arnold, Ola A. Abdelhadi, and Richard M. Scheffler | Published October 2022 | Link to Full Report

On April 29, 2021, Indiana enacted HB 1405, directing a study to be conducted on the market concentration in Indiana’s healthcare sector. This study focuses on the health insurance, hospital, and physician industries. The healthcare sector in Indiana is a microcosm of the healthcare sector in the United States, consisting of dominant health insurers and a delivery system that has evolved into a patchwork of hospital systems that have grown in size and geographic scope via mergers and acquisitions, including vertical acquisitions of physician organizations. This study shows that the healthcare sector in Indiana is not monolithic, neither across the industries we analyzed—health insurance, hospitals, and physicians—nor across its MSAs. Therefore, policies aimed at improving healthcare competition, affordability, and quality need to account for this heterogeneity.

This study was funded by the Indiana Legislative Services Agency (Grant no. 22021).

The report will be presented at the Interim Study Committee on Financial Institutions and Insurance hearing on October 20, 2022.