MANAGED CARE May 2006. ©MediMedia USA
Nothing succeeds like success, except perhaps a monopoly. That's one word (the other is oligopoly) being bandied about in reaction to a study by the American Medical Association that says that too many managed care markets are locked up by just one or two health plans. Using 2005 data, the AMA says that 56 percent of 294 metropolitan areas have single insurers controlling 50 percent or more of the HMO and PPO market. There have been more than 400 health insurer mergers in the last decade, according to the AMA.
"The problem is widespread across the country, and it needs to be looked at," Jim Rohack, an AMA trustee, tells the Baltimore Sun. Specifically, the AMA wants the Department of Justice to open antitrust investigations in some markets, though so far, regulators do not seem interested in pursuing the matter.