The AMA’s annual “Competition in Health Insurance” report, published Nov. 19, found that 95% of metropolitan areas have “highly concentrated” commercial health insurance markets. In 89% of metropolitan areas, one payer has at least a 30% market share in combined HMO, PPO, point-of-sale and exchange markets. In 47% of markets, one insurer had a share of
50% or more.
These are the metro areas where the largest payer controls less than 30% of the market:
Hagerstown-Martinsburg, Md.-W.V.
UnitedHealth: 21% market share
Seattle-Tacoma-Bellevue, Wash.
Premera: 22% market share
Washington-Arlington-Alexandria, D.C.-Va.-Md.-W.V.
CareFirst BCBS: 22% market share
Providence-Warwick, R.I.-Mass.
BCBS Rhode Island: 23% market share
Glens Falls, N.Y.
Elevance: 25% market share
Kingston, N.Y.
UnitedHealth: 25% market share
Albany-Lebanon, Ore.
Cambia: 25% market share
Janesville-Beloit, Wis.
Medica: 25% market share
Wheeling, W.V.-Ohio
Highmark: 26% market share
Grants Pass, Ore.
PacificSource: 26% market share
Denver-Aurora-Lakewood, Colo.
UnitedHealth: 26% market share
Miami-Fort Lauderdale-Pompano Beach, Fla.
Florida Blue: 26% market share
Carson City, Nev.
Prominence: 26% market share
New York-Newark-Jersey City, N.Y.-N.J.-Pa.
UnitedHealth: 26% market share
Portland-Vancouver-Hillsboro, Ore.-Wash.
Kaiser: 26% market share
Springfield, Mass.
Baystate Health: 27% market share
Reno, Nev.
Elevance: 27% market share
Fort Smith, Ark.-Okla.
BCBS Arkansas: 27% market share
Orlando-Kissimmee-Sanford, Fla.
Florida Blue: 27% market share
Allentown-Bethlehem-Easton, Pa.-N.J.
Highmark: 27% market share
Wausau-Weston, Wis.
Elevance: 27% market share
Yakima, Wash.
Premera: 28% market share
Green Bay, Wis.
UnitedHealth: 28% market share
Atlanta-Sandy Springs-Alpharetta, Ga.
Elevance: 28% market share
Phoenix-Mesa-Chandler, Ariz.
UnitedHealth: 28% market share
Boulder, Colo.
Elevance: 28% market share
Bridgeport-Stamford-Norwalk, Conn.
UnitedHealth: 28% market share
Columbus, Ohio
Elevance: 28% market share
Toledo, Ohio
Cigna: 28% market share
Weirton-Steubenville, W.V.-Ohio
Highmark: 28% market share
Youngstown-Warren-Boardman, Ohio-Pa.
Elevance: 28% market share
Medford, Ore.
Cambia: 28% market share
Bremerton-Silverdale-Port Orchard, Wash.
Cambia: 28% market share
San Diego-Chula Vista-Carlsbad, Calif.
Kaiser: 29% market share
Colorado Springs, Colo.
Elevance: 29% market share
Pueblo, Colo.
Elevance: 29% market share
Poughkeepsie-Newburgh-Middletown, N.Y.
UnitedHealth: 29% market share
At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.