Presentation Type
Presentation
Start Date
8-4-2026 11:50 AM
End Date
8-4-2026 12:00 PM
Description
This research examines the relationship between hospital market concentration and health insurance premiums in the Affordable Care Act (ACA) Marketplaces. As hospitals across the United States have increasingly merged or closed, provider markets have become more concentrated, raising questions about whether consolidation improves efficiency or instead increases healthcare costs through greater market power. Using Marketplace premium data, hospital discharge information, and demographic controls from 2014–2017, the study analyzes how hospital concentration, measured by the Herfindahl–Hirschman Index (HHI), affects insurance pricing. The findings show that highly concentrated hospital markets are associated with significantly higher Marketplace premiums, even after controlling for insurer competition and other market characteristics. These results suggest that while consolidation may offer some operational efficiencies, increased provider market power can raise consumer costs and reduce insurance affordability. The study highlights important policy tradeoffs related to antitrust enforcement, healthcare access, and the long-term stability of competitive insurance markets.
Included in
Hospital Concentration and ACA Premiums
This research examines the relationship between hospital market concentration and health insurance premiums in the Affordable Care Act (ACA) Marketplaces. As hospitals across the United States have increasingly merged or closed, provider markets have become more concentrated, raising questions about whether consolidation improves efficiency or instead increases healthcare costs through greater market power. Using Marketplace premium data, hospital discharge information, and demographic controls from 2014–2017, the study analyzes how hospital concentration, measured by the Herfindahl–Hirschman Index (HHI), affects insurance pricing. The findings show that highly concentrated hospital markets are associated with significantly higher Marketplace premiums, even after controlling for insurer competition and other market characteristics. These results suggest that while consolidation may offer some operational efficiencies, increased provider market power can raise consumer costs and reduce insurance affordability. The study highlights important policy tradeoffs related to antitrust enforcement, healthcare access, and the long-term stability of competitive insurance markets.
Comments
Presented health economics research at Bryant University’s Research and Engagement Day analyzing the relationship between U.S. hospital market concentration and Affordable Care Act Marketplace insurance premiums. The project evaluated how hospital consolidation influences insurer bargaining, consumer healthcare costs, and broader policy concerns surrounding affordability, competition, and access to care.