Report: Springfield the most highly concentrated US hospital market

A new report from the nonprofit Health Care Cost Institute found the Springfield metropolitan area is the most highly concentrated inpatient hospital market in the United States.

A highly concentrated market, according to the report, indicates a smaller number of health care systems account for a larger share of hospital admissions, meaning a monopoly may be nearing. The report used the market concentration method Herfindahl-Hirschman Index to score metropolitan areas from 0 to 1, where a 1 represents a monopoly. The study examined 112 metro areas from 2012 to 2016.

The Springfield area’s score was 0.78 for 2016, which was up from 0.62 in 2012. Comparatively, the market with the lowest concentration score was New York City, with a 0.08 in 2016 and 0.05 in 2012, according to the report.

Nearly 92% of patients living in the Springfield metro area sought care inside the market, according to the report. For those who visited inpatient hospitals outside of Springfield, St. Louis was the most major destination.

The two other metro areas studied in Missouri, St. Louis and Kansas, ranked No. 65 and No. 98, respectively, in the study.

On Springfield Business Journal’s list last year of the area’s largest health systems, published Nov. 26, 2018, CoxHealth reported 2017 inpatient volume of 62,660, followed by Mercy Springfield Communities, at 38,034, Citizens Memorial Hospital, at 8,320, and Lakeland Behavioral Health, at 2,552.

The Springfield metro area’s population was around 467,000 in 2018, according to Census Bureau data. According to the Health Care Cost Institute report, hospital markets tend to be more concentrated in smaller metro areas such as Springfield.

The Health Care Cost Institute, according to its website, is partially funded by insurance companies Aetna Inc., Humana Inc., Kaiser Permanente and UnitedHealthcare.