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Report: WellPoint dominates Indiana markets

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WellPoint Inc. holds an overwhelming share of the commercial health insurance market in 13 of Indiana’s 14 largest metros, according to a controversial new study by the American Medical Association.

The report, issued Nov. 28, concludes that Indianapolis-based WellPoint has 56 percent of all Hoosiers enrolled in either employer-sponsored or individually purchased medical policies. The nearest competitor, according to the study, is Minnesota-based UnitedHealthcare, with 12 percent of the statewide commercial market.

The AMA study is based on data collected via surveys by Tennessee-based market research firm HealthLeaders-InterStudy in 2010. It includes enrollment for all types of plans, including PPOs, HMOs, consumer-directed health and point-of-service.

But it fails to include all members of health plans at self-funded employers, according to a critique of the study by the health insurance trade association, American’s Health Insurance Plans. WellPoint referred questions about the AMA study to AHIP.

“Most critically, the data are incomplete and omit various competitive alternatives, with the result that the market share figures do not reliably reflect the actual state of competition in such markets,” AHIP staff members wrote in response to the U.S. Department of Justice about the AMA data.

AHIP‘s concern is to point out that it is the rapid consolidation of hospitals and doctors that is the biggest threat to controlling health care prices. There is some local evidence for that.

But the American Medical Association data still show, either due to market dominance or superior pricing and products, WellPoint holds more than quadruple the number of commercial customers than UnitedHealthcare. And in some markets, the gaps are even wider. Only in Lafayette does UnitedHealthcare come close to WellPoint’s shares.

Here are the market shares for WellPoint and its nearest competitor, shown in the AMA study in Indiana’s 14 largest metropolitan areas. The data include Hoosiers enrolled in any WellPoint health plans, even if that plan is operated out of a different state.

Indianapolis: WellPoint, 59 percent; UnitedHealthcare, 12 percent
Anderson: WellPoint, 68 percent; UnitedHealthcare, 9 percent
Bloomington: WellPoint, 59 percent; Aetna Inc., 16 percent
Columbus: WellPoint, 61 percent; SIHO Insurance Services, 16 percent
Elkhart-Goshen: WellPoint, 63 percent; Cigna Corp., 8 percent
Evansville: WellPoint, 44 percent; Welborn Health Plans, 18 percent
Fort Wayne: WellPoint, 53 percent; Aetna, 15 percent
Gary: WellPoint, 48 percent; UnitedHealthcare, 20 percent
Kokomo: WellPoint, 57 percent; Advantage Health Solutions Inc., 13 percent
Lafayette: WellPoint, 40 percent; UnitedHealthcare, 27 percent
Michigan City-LaPorte: WellPoint, 61 percent; UnitedHealthcare, 11 percent
Muncie: WellPoint, 65 percent; UnitedHealthcare, 9 percent
South Bend-Mishawaka: WellPoint, 42 percent; Blue Cross Blue Shield of Michigan, 20 percent
Terre Haute: WellPoint, 73 percent; UnitedHealthcare, 10 percent

 

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  1. Cramer agrees...says don't buy it and sell it if you own it! Their "pay to play" cost is this issue. As long as they charge customers, they never will attain the critical mass needed to be a successful on company...Jim Cramer quote.

  2. My responses to some of the comments would include the following: 1. Our offer which included the forgiveness of debt (this is an immediate forgiveness and is not "spread over many years")represents debt that due to a reduction of interest rates in the economy arguably represents consideration together with the cash component of our offer that exceeds the $2.1 million apparently offered by another party. 2. The previous $2.1 million cash offer that was turned down by the CRC would have netted the CRC substantially less than $2.1 million. As a result even in hindsight the CRC was wise in turning down that offer. 3. With regard to "concerned Carmelite's" discussion of the previous financing Pedcor gave up $16.5 million in City debt in addition to the conveyance of the garage (appraised at $13 million)in exchange for the $22.5 million cash and debt obligations. The local media never discussed the $16.5 million in debt that we gave up which would show that we gave $29.5 million in value for the $23.5 million. 4.Pedcor would have been much happier if Brian was still operating his Deli and only made this offer as we believe that we can redevelop the building into something that will be better for the City and City Center where both Pedcor the citizens of Carmel have a large investment. Bruce Cordingley, President, Pedcor

  3. I've been looking for news on Corner Bakery, too, but there doesn't seem to be any info out there. I prefer them over Panera and Paradise so can't wait to see where they'll be!

  4. WGN actually is two channels: 1. WGN Chicago, seen only in Chicago (and parts of Canada) - this station is one of the flagship CW affiliates. 2. WGN America - a nationwide cable channel that doesn't carry any CW programming, and doesn't have local affiliates. (In addition, as WGN is owned by Tribune, just like WTTV, WTTK, and WXIN, I can't imagine they would do anything to help WISH.) In Indianapolis, CW programming is already seen on WTTV 4 and WTTK 29, and when CBS takes over those stations' main channels, the CW will move to a sub channel, such as 4.2 or 4.3 and 29.2 or 29.3. TBS is only a cable channel these days and does not affiliate with local stations. WISH could move the MyNetwork affiliation from WNDY 23 to WISH 8, but I am beginning to think they may prefer to put together their own lineup of syndicated programming instead. While much of it would be "reruns" from broadcast or cable, that's pretty much what the MyNetwork does these days anyway. So since WISH has the choice, they may want to customize their lineup by choosing programs that they feel will garner better ratings in this market.

  5. The Pedcor debt is from the CRC paying ~$23M for the Pedcor's parking garage at City Center that is apprased at $13M. Why did we pay over the top money for a private businesses parking? What did we get out of it? Pedcor got free parking for their apartment and business tenants. Pedcor now gets another building for free that taxpayers have ~$3M tied up in. This is NOT a win win for taxpayers. It is just a win for Pedcor who contributes heavily to the Friends of Jim Brainard. The campaign reports are on the Hamilton County website. http://www2.hamiltoncounty.in.gov/publicdocs/Campaign%20Finance%20Images/defaultfiles.asp?ARG1=Campaign Finance Images&ARG2=/Brainard, Jim

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