{"title":"非营利性医院合并:对医疗成本和利用的影响。","authors":"Maysam Rabbani","doi":"10.1007/s10754-021-09303-8","DOIUrl":null,"url":null,"abstract":"<p><p>I use a 2010 non-profit hospital merger in Ohio to study the effect of market concentration on market outcomes. Using the Synthetic Control Method and Truven MarketScan data, I document three findings. First, courts are lenient to non-profit mergers, and I cast doubt on this practice by showing that the studied merger led to a 123% increase in the payments for inpatient childbirth services. Second, I provide the first empirical evidence for the conjecture that mergers increase out-of-pocket payments and reduce the utilization of care. Last, I show that the effect of market power on market outcomes is asymmetric: the increase in payments and welfare loss created by a merger persist after the merger is rescinded. Thus, even successful FTC challenges may not revert the effect of harmful mergers, and it is essential to deny such mergers before they proceed.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"21 4","pages":"427-455"},"PeriodicalIF":1.5000,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10754-021-09303-8","citationCount":"6","resultStr":"{\"title\":\"Non-profit hospital mergers: the effect on healthcare costs and utilization.\",\"authors\":\"Maysam Rabbani\",\"doi\":\"10.1007/s10754-021-09303-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>I use a 2010 non-profit hospital merger in Ohio to study the effect of market concentration on market outcomes. Using the Synthetic Control Method and Truven MarketScan data, I document three findings. First, courts are lenient to non-profit mergers, and I cast doubt on this practice by showing that the studied merger led to a 123% increase in the payments for inpatient childbirth services. Second, I provide the first empirical evidence for the conjecture that mergers increase out-of-pocket payments and reduce the utilization of care. Last, I show that the effect of market power on market outcomes is asymmetric: the increase in payments and welfare loss created by a merger persist after the merger is rescinded. Thus, even successful FTC challenges may not revert the effect of harmful mergers, and it is essential to deny such mergers before they proceed.</p>\",\"PeriodicalId\":44403,\"journal\":{\"name\":\"International Journal of Health Economics and Management\",\"volume\":\"21 4\",\"pages\":\"427-455\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2021-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1007/s10754-021-09303-8\",\"citationCount\":\"6\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Health Economics and Management\",\"FirstCategoryId\":\"96\",\"ListUrlMain\":\"https://doi.org/10.1007/s10754-021-09303-8\",\"RegionNum\":4,\"RegionCategory\":\"经济学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/4/5 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"BUSINESS, FINANCE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Health Economics and Management","FirstCategoryId":"96","ListUrlMain":"https://doi.org/10.1007/s10754-021-09303-8","RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/4/5 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"BUSINESS, FINANCE","Score":null,"Total":0}
Non-profit hospital mergers: the effect on healthcare costs and utilization.
I use a 2010 non-profit hospital merger in Ohio to study the effect of market concentration on market outcomes. Using the Synthetic Control Method and Truven MarketScan data, I document three findings. First, courts are lenient to non-profit mergers, and I cast doubt on this practice by showing that the studied merger led to a 123% increase in the payments for inpatient childbirth services. Second, I provide the first empirical evidence for the conjecture that mergers increase out-of-pocket payments and reduce the utilization of care. Last, I show that the effect of market power on market outcomes is asymmetric: the increase in payments and welfare loss created by a merger persist after the merger is rescinded. Thus, even successful FTC challenges may not revert the effect of harmful mergers, and it is essential to deny such mergers before they proceed.
期刊介绍：
The focus of the International Journal of Health Economics and Management is on health care systems and on the behavior of consumers, patients, and providers of such services. The links among management, public policy, payment, and performance are core topics of the relaunched journal. The demand for health care and its cost remain central concerns. Even as medical innovation allows providers to improve the lives of their patients, questions remain about how to efficiently deliver health care services, how to pay for it, and who should pay for it. These are central questions facing innovators, providers, and payers in the public and private sectors. One key to answering these questions is to understand how people choose among alternative arrangements, either in markets or through the political process. The choices made by healthcare managers concerning the organization and production of that care are also crucial. There is an important connection between the management of a health care system and its economic performance. The primary audience for this journal will be health economists and researchers in health management, along with the larger group of health services researchers. In addition, research and policy analysis reported in the journal should be of interest to health care providers, managers and policymakers, who need to know about the pressures facing insurers and governments, with consequences for regulation and mandates. The editors of the journal encourage submissions that analyze the behavior and interaction of the actors in health care, viz. consumers, providers, insurers, and governments. Preference will be given to contributions that combine theoretical with empirical work, evaluate conflicting findings, present new information, or compare experiences between countries and jurisdictions. In addition to conventional research articles, the journal will include specific subsections for shorter concise research findings and cont ributions to management and policy that provide important descriptive data or arguments about what policies follow from research findings. The composition of the editorial board is designed to cover the range of interest among economics and management researchers.Officially cited as: Int J Health Econ ManagFrom 2001 to 2014 the journal was published as International Journal of Health Care Finance and Economics. (Articles published in Vol. 1-14 officially cited as: Int J Health Care Finance Econ)
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