The AMA’s annual “Competition in Health Insurance” report, published in December, found that 73% of metropolitan areas have “highly concentrated” commercial health insurance markets. In 90% of metropolitan areas, one payer has at least a 30% market share in combined HMO, PPO, point-of-sale and exchange markets. In 48% of markets, one insurer had a share of
50% or more.
These are the metro areas where the largest payer controls less than 30 percent of the market:
Providence-Warwick, R.I.-Mass.
BCBS Rhode Island: 22% market share
Hagerstown-Martinsburg, Md.-W.V.
CareFirst BCBS: 22% market share
Seattle-Tacoma-Bellevue, Wash.
Premera BCBS: 23% market share
Albany-Lebanon, Ore.
Cambia Health Solutions: 24% market share
Eugene-Springfield, Ore.
PacificSource: 24% market share
Grants Pass, Ore.
PacificSource: 25% market share
Washington-Arlington-Alexandria, D.C.-Va.-Md.-W.V.
CareFirst BCBS: 25% market share
Denver-Aurora-Lakewood, Colo.
UnitedHealth Group: 25% market share
Portland-Vancouver-Hillsboro, Ore.-Wash.
Kaiser Permanente: 25% market share
Eau Claire, Wis.
Elevance Health: 25% market share
Janesville-Beloit, Wis.
Quartz: 25% market share
New York-Newark-Jersey City, N.Y.-N.J.-Pa.
UnitedHealth Group: 26% market share
Miami-Fort Lauderdale-Pompano Beach, Fla.
Florida Blue: 26% market share
Carson City, Nev.
Elevance Health: 26% market share
Springfield, Mass.
Baystate: 27% market share
Boulder, Colo.
Elevance Health: 27% market share
Colorado Springs, Colo.
Elevance Health: 27% market share
Allentown-Bethlehem-Easton, Pa.-N.J.
Highmark: 27% market share
Orlando-Kissimmee-Sanford, Fla.
Florida Blue: 28% market share
Poughkeepsie-Newburgh-Middletown, N.Y.
UnitedHealth Group: 28% market share
Salem, Ore.
Kaiser Permanente: 28% market share
Fond du Lac, Wis.
UnitedHealth Group: 28% market share
Green Bay, Wis.
UnitedHealth Group: 28% market share
Wausau-Weston, Wis.
Elevance Health: 28% market share
San Diego-Chula Vista-Carlsbad, Calif.
Kaiser Permanente: 29% market share
Pueblo, Colo.
Elevance Health: 29% market share
Palm Bay-Melbourne-Titusville, Fla.
Cigna: 29% market share
Kingston, N.Y.
UnitedHealth Group: 29% market share
Fargo, N.D.-Minn.
BCBS North Dakota: 29% market share
Columbus, Ohio
Elevance Health: 29% market share
Toledo, Ohio
Elevance Health: 29% market share
Weirton-Steubenville, W.V.-Ohio
Highmark: 29% market share
Medford, Ore.
Cambia Health Solutions: 29% market share
Yakima, Wash.
Premera BCBS: 29% market share
Wheeling, W.V.-Ohio
Highmark: 29% market share