United Health dominates Medicare Advantage market

NEW YORK - There is little or no competition in the Medicare Advantage market in 97% of U.S. counties, according to a new study from the Commonwealth Fund.

Among the nation's 2,933 counties, only one—Riverside, Calif.—qualified as a competitive market and only 80 qualified as moderately competitive.

“Allowing private health insurers to play a larger role in Medicare is often suggested as a way to control Medicare costs and improve quality of care,” said Stuart Guterman, senior scholar in residence at AcademyHealth and coauthor of the study, in a press release. “The idea is if there are more insurers, they'll fight for customers by lowering premiums and improving quality. For that to happen, however, we need to have enough insurers in a given market—and this study shows that, overwhelmingly, that isn't the case.”

The Commonwealth Fund found that six insurers dominate the markets in the 100 counties with the most Medicare beneficiaries. United Health had the greatest number of Medicare Advantage enrollees in 38 counties, while Blue Cross affiliates had the greatest enrollment in 13 counties and Humana in 12 counties.

While both urban and rural markets lack competition, rural markets are the least competitive, the Commonwealth Fund found.

The Commonwealth Fund is a private foundation that aims to promote a high-performing healthcare system that achieves better access, improved quality and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children and elderly adults.