Study Results from University of Pennsylvania Provide New Insights into Managed Care (Partial rating area offering and tests for anticompetitive market segmentation in the ACA Marketplaces): Managed Care

2025 NOV 20 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Investigators discuss new findings in Managed Care. According to news reporting from Philadelphia, Pennsylvania, by NewsRx journalists, research stated, “To limit price variation across consumers in the Health Insurance Marketplaces, the Patient Protection and Affordable Care Act (ACA) mandates that insurance plans be uniformly priced across multiple counties within the same geographic rating area. However, the ACA does not require insurers to offer plans in every county, creating the potential for partial rating area offering.”

The news correspondents obtained a quote from the research from the University of Pennsylvania, “Using data from the federally-facilitated Marketplaces, we find that selective participation is both prevalent and persistent throughout the 2016-2022 period. We investigate whether this selective offering reflects anticompetitive market segmentation. In six of the seven years, the evidence is inconsistent with collusive motives.”

According to the news reporters, the research concluded: “Only in 2018, a year characterized by a particularly low number of insurers with extensive multimarket contact, do we find evidence suggesting anticompetitive motives were among the drivers of selective participation within rating areas.”

This research has been peer-reviewed.

For more information on this research see: Partial rating area offering and tests for anticompetitive market segmentation in the ACA Marketplaces. Journal of Health Economics, 2025;104:103080. Journal of Health Economics can be contacted at: Elsevier, Radarweg 29, 1043 Nx Amsterdam, Netherlands. (Elsevier - www.elsevier.com; Journal of Health Economics - http://www.journals.elsevier.com/journal-of-health-economics/)

Our news journalists report that additional information may be obtained by contacting Hanming Fang, University of Pennsylvania, Dept. of Economics, 133 S. 36th Street, Philadelphia, PA 19104, United States.

Publisher contact information for the Journal of Health Economics is: Elsevier, Radarweg 29, 1043 Nx Amsterdam, Netherlands.

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