About 73% of health insurance markets in the metropolitan
statistical areas were highly concentrated in 2020, while in 46% of those
markets, a single insurer's market share reached at least 50%, according to the
2021 edition of an annual report from the American Medical Association. The consolidation
trend is also pronounced with providers, a trend that is likely to be
accelerated due to revenue shortfalls caused by the pandemic. A Health Affairs study found that the share of primary care
physicians affiliated with vertically integrated health systems increased from
38% in 2016 to 49% in 2018, while more than half of physicians and 72% of
hospitals were affiliated with one of 637 health systems in 2018. Yet several studies suggested that there is no clear evidence
that provider consolidation leads to higher quality of care.
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