A study of health insurance market competitiveness in 385 metropolitan areas across the United States finds that two-thirds of the areas have a commercial health insurer with at least 50 percent market share in the HMO, PPO or POS markets.

That’s one of the findings from the American Medical Association’s annual report on commercial payer competition. Overall, 70 percent of the metropolitan areas have a “significant absence” of competition, according to the 2012 AMA Competition in Health Insurance: A Comprehensive Study of U.S. Markets.

Alabama is the least competitive commercial health insurance market in the nation, according to the association. Others in the top ten, in order, are Hawaii, Michigan, Delaware, Alaska, North Dakota, South Carolina, Rhode Island, Wyoming and Nebraska.

The report, which breaks out the HMO, PPO, POS, and Consumer-Driven Health Plan markets, is available here, free to AMA members and costing $150 for others.

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