policy
Consolidation Is Shrinking Patients’ Choices
Across the country, major insurance companies are acquiring doctors, clinics, pharmacies, pharmacy benefit managers, and other parts of the healthcare system. As insurers expand their control across the healthcare system, patients may appear to have choices, but those choices are increasingly controlled by a few large organizations.
Large insurers are also better positioned to use their scale to gain negotiating power, while smaller insurers and independent physician practices face greater pressure to sell, merge, or leave the market. Over time, that weakens competition and gives dominant players even more control over patients’ healthcare choices.
Insurer practices are making
narrow networks worse
Insurers have enormous power to decide which physicians participate in their networks and how much they are paid. When insurers offer take-it-or-leave-it contracts with payment rates that do not reflect the cost of delivering care, independent practices face an impossible choice: accept unsustainable terms or remain outside the network.
Either way, patients lose.
Inadequate reimbursement can force practices to reduce services, stop accepting certain insurance plans, or close altogether. That leaves patients searching through provider directories that may look extensive on paper but offer far fewer real options in practice.
Insurers should not be allowed to charge high premiums while offering networks that fail to provide meaningful access to doctors and specialists.
For patients, consolidation can mean:
- Fewer independent doctors and community-based practices
- Narrower insurance networks and fewer in-network specialists
- Longer travel and wait times for appointments
- Less control over where they receive care
- Higher premiums and healthcare costs
And as insurers acquire more doctors, pharmacies, clinics, and other parts of the healthcare system, having multiple options does not necessarily mean patients have real choices. Those options can increasingly be owned or controlled by the same handful of large organizations.
A health insurance card is not the same as access to healthcare.
Coverage only works when patients can find the right doctors in their network and receive care when they need it.
A competitive healthcare market gives patients and employers real choices and encourages providers to compete to deliver better care at lower costs. Consolidation moves the system in the opposite direction.