10 states with the least competitive HMO markets
September 28, 2015 8:30 AM
Overview:
Benefit advisers, employers and other industry insiders fear merger and acquisition activity in the health insurance industry is eroding market competition, a trend that could lead to increased premiums for employers and individuals. Recent research from the American Medical Association identified the top 10 states with the least competitive HMO markets based on market concentration levels as determined by the HerfindahlHirschman Index or HHIa measure used by the U.S. Department of Justice and the Federal Trade Commission.
The HHI number can range from close to zero to 10,000. DOJ considers a market with a result of less than 1,000 to be a competitive marketplace; a result of 1,000-1,800 to be a moderately concentrated marketplace; and a result of 1,800 or greater to be a highly concentrated marketplace.
The HHI number can range from close to zero to 10,000. DOJ considers a market with a result of less than 1,000 to be a competitive marketplace; a result of 1,000-1,800 to be a moderately concentrated marketplace; and a result of 1,800 or greater to be a highly concentrated marketplace.
10) Colorado
HMO HHI: 6,387
HMO with the largest market share: Kaiser with 79%
HMO with the second largest market share: Wellpoint with 6%
HMO with the largest market share: Kaiser with 79%
HMO with the second largest market share: Wellpoint with 6%
9) Idaho
HMO HHI: 6,627
HMO with the largest market share: Group Health Cooperative with 80%
HMO with the second largest market share: Intermountain with 15%
HMO with the largest market share: Group Health Cooperative with 80%
HMO with the second largest market share: Intermountain with 15%
8) Nevada
HMO HHI: 6,676
HMO with the largest market share: UnitedHealthcare with 81%
HMO with the second largest market share: Renown Health with 8%
HMO with the largest market share: UnitedHealthcare with 81%
HMO with the second largest market share: Renown Health with 8%
7) North Dakota
HMO HHI: 6,750
HMO with the largest market share: Sanford with 80%
HMO with the second largest market share: Dakotacare with 19%
HMO with the largest market share: Sanford with 80%
HMO with the second largest market share: Dakotacare with 19%
6) Nebraska
HMO HHI: 7,138
HMO with the largest market share: Kaiser with 79%
HMO with the second largest market share: Wellpoint with 6%
HMO with the largest market share: Kaiser with 79%
HMO with the second largest market share: Wellpoint with 6%
5) Louisiana
HMO HHI: 7,875
HMO with the largest market share: Louisiana Health Service and Indemnity Company (BCBS) with 88%
HMO with the second largest market share: Vantage Health with 5%
HMO with the largest market share: Louisiana Health Service and Indemnity Company (BCBS) with 88%
HMO with the second largest market share: Vantage Health with 5%
4) Utah
HMO HHI: 8,189
HMO with the largest market share: Intermountain with 90%
HMO with the second largest market share: Aetna with 10%
HMO with the largest market share: Intermountain with 90%
HMO with the second largest market share: Aetna with 10%
3) South Carolina
HMO HHI: 8,276
HMO with the largest market share: BCBS SC with 91%
HMO with the second largest market share: Aetna with 4%
HMO with the largest market share: BCBS SC with 91%
HMO with the second largest market share: Aetna with 4%
2) Vermont
HMO HHI: 8,857
HMO with the largest market share: BCBS VT with 94%
HMO with the second largest market share: MVP Health Care with 4%
HMO with the largest market share: BCBS VT with 94%
HMO with the second largest market share: MVP Health Care with 4%
1) Alabama
HMO HHI: 9,437
HMO with the largest market share: Triton (Viva Health) with 97%
HMO with the second largest market share: UnitedHealthcare with 2%
HMO with the largest market share: Triton (Viva Health) with 97%
HMO with the second largest market share: UnitedHealthcare with 2%
