Five Essays on Competition and Regulation in Health Care Markets
Author: Kurt Richard Brekke
Publisher:
Published: 2003
Total Pages: 142
ISBN-13:
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Essays on Competition in Health Care Markets
Author: Xing Wu
Publisher:
Published: 2018
Total Pages: 0
ISBN-13:
DOWNLOAD EBOOKOver the last decades, health economics has turned into one of the most active research fields within economics. The structure of health care markets varies enormously across countries, largely influenced by competition among suppliers, the regulation of markets and patient preferences. This dissertation presents an analysis of health care markets especially focusing on price competition and quality competition. Under price competition, a pair of asymmetric pure strategy price equilibria exists in a model with income constraints for the specific case that two physicians locate at the maximum distance from each other and patients pay the same marginal transportation cost. Under quality competition, I investigate the interplay of market transparency and semi-altruism - a specific and interesting aspect unique to markets for health care. Market transparency and semi-altruism show ambiguous effects on welfare. The more altruistic physicians provides weakly higher quality than the less altruistic one. Moreover, I explore individual and social incentives for hospital mergers and their interaction with transparency and find that higher transparency does not always lead to higher quality and higher social welfare. The results indicate that quality is lower after merger. A hospital merger leads to a higher social welfare if the efficiency gains from the merger are sufficiently large. ; eng
Three Essays on Market Structure, Competition, Prices, Health Spending, and Quality in the US Healthcare System
Author: James R Godwin
Publisher:
Published: 2022
Total Pages: 192
ISBN-13:
DOWNLOAD EBOOKThe United States spends a larger percentage of GDP on healthcare than any other OECD nation, and yet it performs poorly on measures of access, process quality and outcomes relative to other wealthy nations. One hypothesis that may explain the relatively poor performance of the United States' healthcare system per dollar spent is that markets for hospitals, physician services, and insurance are highly consolidated and lack competition. This dissertation contributes to the body of literature seeking to measure healthcare market structure and assess the relationship between this market structure and unit prices, overall spending, and healthcare quality. The first paper in this dissertation, "The Association between Hospital-Physician Vertical Integration and Outpatient Physician Prices Paid by Commercial Insurers: New Evidence," demonstrates market-level associations between vertical integration among hospitals and physicians and higher prices for outpatient care. The second essay, "How Hospital-Owned Physician Organizations are Associated with Healthcare Prices, Expenditures, and Quality," analyzes vertical integration and prices, quality, and total patient spending, building on the findings of the first essay using physician and hospital level claims data. This study finds that vertical integration is associated with higher levels of annual spending for patients attributed to vertically integrated providers, but interpretation of association between vertical integration and outpatient prices is confounded by pre-intervention trends. Analysis of CMS hospital outcome measures does not show associations between vertical integration at a hospital level and quality. Finally, the third essay, "Automated Delineation of Hospital Market Boundaries in California," explores geographic market definition in healthcare, an important topic in research and antitrust action, while assessing the application of community detection methods in this field. This study finds that community detection methods group hospitals with higher accuracy than other geographic markets as measured by patient flows and may offer promise for merger screening, research on market concentration, and research on geographic variation in healthcare. The final chapter reviews overarching limitations of the dissertation, outlines directions for future research, and comments on potential policy approaches to promote competition and address the symptoms that may result from highly consolidated healthcare markets
Competition and Quality in Health Care Markets
Author: Martin Gaynor
Publisher: Now Publishers Inc
Published: 2006
Total Pages: 83
ISBN-13: 1601980078
DOWNLOAD EBOOKProvides an economic assessment of the impact of competition on quality in health care markets. This book offers performance standards for competition; findings from economic theory; and, empirical evidence on health care competition and quality.
Improving Healthcare
Author: David Hyman
Publisher: Springer Science & Business Media
Published: 2007-04-21
Total Pages: 436
ISBN-13: 0387257527
DOWNLOAD EBOOKImproving Healthcare: A Dose of Competition systematically examines the American health care system from a competition-oriented perspective. The volume surveys the performance of each major sector of the health care system, and identifies impediments to more effective competition. Improving Healthcare examines such issues as competition v. regulation, public and private sector approaches to health care financing, cross-subsidies, licensure, provider market concentration, financial and clinical integration, payment for performance, quality, pharmacy benefit managers, direct-to-consumer advertising of pharmaceuticals, certificates of need, mandates, unionization, the significance of organizational status (nonprofit v. for-profit), and the role of antitrust and consumer protection in health care. It offers concrete recommendations to improve the quality and cost-effectiveness of the American health care marketplace.
Essays on the Role of Government Regulation and Policy in Health Care Markets
Author: Grayson L. Forlines
Publisher:
Published: 2018
Total Pages: 210
ISBN-13:
DOWNLOAD EBOOKIndustrial Organization of Health Care Markets
Author: Benjamin R. Handel
Publisher:
Published: 2021
Total Pages:
ISBN-13:
DOWNLOAD EBOOKIn this paper we outline the tools that have been developed to model and analyze competition and regulation in health care markets, and describe particular papers that apply them to policy-relevant questions. We focus particularly on the I.O. models and empirical methods and analyses that researchers have formulated to address policy-relevant questions, although we also provide an overview of the institutional facts and findings that inform them. We divide the chapter into two broad sections: (i) papers considering competition and price-setting among insurers and providers and (ii) papers focused specifically on insurance and market design. The former set of papers is largely concerned with models of oligopolistic competition; it is often focused on the US commercial insurance market where prices are market-determined rather than being set administratively. The latter focuses on insurance market design with an emphasis on issues raised by asymmetric information, leading to adverse selection and moral hazard. In addition, we discuss the literature on consumer choice frictions in this market and the significant implications of those frictions for I.O. questions.
Competition and Regulation in Health Care Markets
Author:
Publisher:
Published: 1981
Total Pages: 190
ISBN-13:
DOWNLOAD EBOOKEssays on Competition in Health Care Markets
Author: Emily Walden
Publisher:
Published: 2017
Total Pages: 0
ISBN-13:
DOWNLOAD EBOOKIn these essays, I empirically estimate the impact of interactions between primary care physicians (PCPs) and specialists on physician behavior. In the first chapter, I examine the impact that the acquisition of PCPs by firms employing specialists has on patient referral patterns in markets where integration takes place. In the second chapter, I estimate a model of physician entry behavior to understand the extent to which PCPs and specialists consider the number of physicians of the other type in the market when selecting which markets to enter.
Essays in the Economics of Health Care and the Regulation of Medical Technology
Author: Ariel Dora Stern
Publisher:
Published: 2014
Total Pages:
ISBN-13:
DOWNLOAD EBOOKThe first chapter of this dissertation explores how the regulatory approval process affects innovation incentives in medical technologies. While prior studies of medical innovation under regulation have found an early mover regulatory advantage for drugs, I find the opposite to be true for medical devices. Using detailed data on over three decades of high-risk medical device approval times in the United States, I show pioneer entrants spend approximately 34 percent (7.2 months) longer in the approval process than the first follow-on innovator. Back-of-the-envelope calculations suggest that the opportunity cost of capital of a delay of this length is upwards of 7 percent of the total cost of bringing a new device to market. I consider how different types of regulatory uncertainty affect approval times and find that a product's technological novelty is largely unrelated to time spent under review. In contrast, uncertainty about application content and format appears to play a large role: when objective guidelines for evaluation are published, approval times quicken for subsequent entrants. Finally, I consider how the regulatory process affects firms' market entry strategies and find that financially constrained firms are less likely to enter new device markets as pioneers.
