Commonwealth Medicine report analyzes NH health insurance rates

By Jennifer Rosinski

UMass Medical School Communications

October 02, 2013

report from the Center for Health Law and Economics (CHLE) that analyzed the current health insurance payment system in New Hampshire and factors affecting premiums and health care costs was presented at the New Hampshire Insurance Department’s (NHID) annual rate hearing in Concord, N.H. on Sept. 26.

“New Hampshire’s Health Insurance Market and Provider Payment System: An Analysis of Stakeholder Views” was produced by a team from CHLE, a unit within the Commonwealth Medicine division of UMass Medical School, and its partner Freedman HealthCare LLC. The UMMS authors included Michael G. Grenier, MPA, Katharine London, MS, Amanda Littell-Clark, JD, MPH, Rebecca Kushner, MPA, and Javeeria Ghani, MPH. The Freedman HealthCare authors included John Freedman, MD, MBA and Missy Garrity, MBA, PMP.

The report was referred to and praised by several insurer representatives testifying at the hearing. It was also mentioned in articles published by New Hampshire Public Radio and the Valley News.

According to the report, New Hampshire’s health care premiums and deductibles are among the highest in the country. The high cost of health care was attributed to a variety of factors, including:

  • A lack of provider and carrier competition;
  • A lack of competition due to carrier dominance;
  • A trend toward consolidation as hospitals buy up physician practices;
  • An increase in the use of higher cost sharing products; and
  • Limited use of alternative payment arrangements in 2011.


Cost reduction has been successful for some carriers through plan design changes that include cost sharing and care delivery reform, the report said. Carriers and providers called on state leadership to identify and share industry best practices, develop new payment models, and to develop a long-term health care vision for New Hampshire.

The report was based, in part, on interviews with 26 health care industry stakeholders, including providers, carriers and consumers. Those interviews were supplemented with an analysis of the 2011 New Hampshire Comprehensive Health Care Information System, as well as reports from NHID and nationally published literature. The report’s authors also relied on data received from three large New Hampshire carriers regarding payment methods and plan design.