The top three large-group insurers control an average of 82.2% of the market share in each state, nearly twice the combined average market share of each state’s largest health systems, according to a study about consolidation in health care released May 1 by the Association of American Medical Colleges. 

"When the market share of an insurer far exceeds the market share of an individual health system — as is the case in most states, according to our analysis — that can negatively impact the amount that insurers are willing to pay hospitals and health systems for patient care," the study notes. 

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