The American Medical Association has identified the insurance industry giants with the largest shares of the commercial health insurance, Medicare Advantage and public health exchange markets in 2023.
The report examined 381 metropolitan statistical areas, the 50 states and the District of Columbia and tabulated market shares for the two largest health insurance companies, according to a Dec. 12 release sent to Becker's.
Here are five things to know about the Medicare Advantage market, per the AMA:
1. At the national level, the 10 largest Medicare Advantage providers by market share were:
1. UnitedHealth Group (28%)
2. Humana (18%)
3. CVS (Aetna) (11%)
4. Kaiser Permanente (6%)
5. Elevance Health (6%)
6. Centene Corp. (5%)
7. Cigna (2%)
8. Blue Cross Blue Shield of Michigan (2%)
9. Highmark (1%)
10. SCAN (1%)
2. In 31% of metropolitan statistical areas, one health insurer held a market share of at least 50%.
3. UnitedHealth Group was the largest health insurer by market share in 42% of metropolitan statistical areas, followed by Humana with a market share lead in 22% of metropolitan statistical areas and CVS (Aetna) with a market share lead in 7% of metropolitan statistical areas.
4. Under current federal guidelines that define the regulatory threshold for markets to be considered highly concentrated, 71% of metropolitan statistical area-level markets were highly concentrated in 2022, down from 87% in 2017.
5. Under proposed federal guidelines supported by the AMA, 97% of metropolitan statistical area-level markets would be highly concentrated. A lower threshold for what constitutes a highly concentrated market may increase scrutiny of health insurance mergers and limit harmful consolidation, the release said.