Insurers own less than 5% of primary care providers, but this share has grown significantly since 2016, a study published in the July issue of Health Affairs Scholar found.
Researchers calculated the share of primary care providers owned by Optum, Aetna, Humana, Cigna and Elevance Health.
Insurers operated 4.2% of the national primary care market by service volume in 2023, up from less than 1% in 2016.
Here are five things to know:
- UnitedHealth Group’s Optum accounted for the largest share of payer-owned primary care providers. Optum owned 2.7% of the national primary care market.
- The share of primary care markets owned by insurers varied by geography. In three counties — Snohomish County, Wash.; Contra Costa County, Calif.; and Clark County, Nev. — Optum owned more than one-third of the primary care market.
- Overall, 15% of the U.S. population lives in counties where payers controlled more than 10% of the primary care market.
- Insurers tended to control less of the primary care market in counties with less concentrated hospital markets.
- Payer-owned primary care accounted for around 6% of Medicare Advantage claims, compared to around 2% of traditional Medicare claims.
The effect of payer-owned primary care cost, competition and patient outcomes is unclear, the study’s authors wrote.
The study was conducted by researchers at Washington, D.C.-based Brookings Institution, and the Division of Health Policy and Economics at New York City-based Weill Cornell Medical College.
Read the full study here.
