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首页> 外文期刊>Journal of health economics >Dropped out or pushed out? Insurance market exit and provider market power in Medicare Advantage
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Dropped out or pushed out? Insurance market exit and provider market power in Medicare Advantage

机译：退出还是退出？ Medicare Advantage中的保险市场退出和提供者市场力量

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This paper explores how provider and insurer market power affect which markets an insurer chooses to operate in. A 2011 policy change required that certain private insurance plans in Medicare form provider networks de novo; in response, insurers cancelled two-thirds of the affected plans. Using detailed data on pre-policy provider and insurer market structure, I compare markets where insurers built networks to those they exited. Overall, insurers in the most concentrated hospital and physician markets were 9 and 13 percentage points more likely to exit, respectively, than those in the least concentrated markets. Conversely, insurers with more market power were less likely to exit than those with less, and an insurer's market power had the largest effect on exit in concentrated hospital markets. These findings suggest that concentrated provider markets contribute to insurer exit and that insurers with less market power have more difficulty surviving in concentrated provider markets. Published by Elsevier B.V.
机译：本文探讨了提供者和保险人的市场力量如何影响保险人选择在哪个市场开展业务。2011年的政策变更要求从新建立的医疗服务提供者网络中的某些Medicare私人保险计划；作为回应，保险公司取消了三分之二的受影响计划。我使用有关政策前提供者和保险人市场结构的详细数据，比较了保险人建立网络和退出市场的市场。总体而言，与最不集中的市场相比，医院和医师市场最集中的保险公司退出的可能性分别高出9和13个百分点。相反，拥有市场支配力的保险公司退出的可能性要小于拥有市场支配力的保险公司退出的可能性，而保险公司的市场支配力对集中医院市场的退出影响最大。这些发现表明，集中的提供者市场有助于保险公司退出，而市场力量较小的保险公司在集中的提供者市场中生存的困难更大。由Elsevier B.V.发布

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