No significant association between anesthesia group concentration and private insurer payments in the United States.
Anesthesiology
; 123(3): 507-14, 2015 Sep.
Article
en En
| MEDLINE
| ID: mdl-26192028
ABSTRACT
BACKGROUND:
Markets for physician services are becoming increasingly concentrated, with many areas being dominated by a few groups. Antitrust authorities are concerned that increasing concentration will lead to inappropriately high payments for physician services from private insurers. The authors examined the association between market concentration and private insurer payments for anesthesia services.METHODS:
The authors obtained data on average payments from private insurers for five commonly used anesthesia Current Procedure Terminology codes for physicians located in 229 counties in the United States between 2002 and 2010. The authors calculated a measure of market concentration (the Herfindahl-Hirschman Index [HHI]) for anesthesiologists in each county using Medicare claims data. The authors then estimated the association between market concentration and private insurer payments using a difference-in-differences approach to minimize confounding.RESULTS:
Private insurer payments to anesthesiologists in more concentrated markets were not significantly different from payments in less concentrated markets. Compared with the 25% of counties with the least concentration (counties with an HHI in the 0th to 25th percentile), payments in counties in the 25th to 50th percentile of HHI were approximately 0.51% less (95% CI, -2.3 to 1.3%, P = 0.95), whereas payments in counties in the 50th to 75th percentile of HHI were approximately 2.8% less (95% CI, -6.7 to 1.4%, P = 0.41) and payments in counties in the 75th to 100th percentile were approximately 3.1% less (95% CI, -8.1 to 1.2%, P = 0.32).CONCLUSION:
Increasing market concentration of anesthesia groups is not associated with significantly greater payments from private insurers.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Práctica Privada
/
Gastos en Salud
/
Aseguradoras
/
Seguro de Salud
/
Anestesia
Tipo de estudio:
Risk_factors_studies
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Anesthesiology
Año:
2015
Tipo del documento:
Article