2016 ASSA: How does consumer inattention affect pricing?
Why do Medicare patients choose to stay in their current Part D prescription drug plan or switch to another? Are they rational actors maximizing their their financial benefit or do other factors play a...
View ArticleDid the ACA cause industry consolidation?
The Affordable Care Act (ACA)–among other things–mandated a number of reforms to the Medicare reimbursement system. For instance, the ACA created Accountable Care Organizations (ACOs) and bundled...
View ArticleDo hospital purchases of physician practices increase or decrease prices?
The effect of health care industry consolidation on prices is a question argued about by many including researchers, economists, anti-trust, lawyers, regulators and more. There is evidence that health...
View ArticleAre hospitals gobbling up physician practices?
Conventional wisdom holds that in recent years the answer is ‘yes’, however what does the data show? A paper by Nipay, Richards and Penso (2018) uses an SK&A survey of physician office practices...
View ArticleMarket consolidation in California
Yesterday, I discussed the idea of managed competition in California. One of the original tenets of managed competition was insurers having integrated, mutually exclusive provider networks. This...
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Trends in hospital consolidation
The National Institute for Health Care Management (NIHCM) has some nice slides describing trends in hospital consolidation. First, we see a trend of increased hospitalizations over time. Further,...
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For-profit chains are gobbling up local hospitals. What trend in the broader...
One trend in recent years is how many hospitals are being purchased by large regional or national hospital chains. An April 2019 slide deck from the NIHCM Foundation shows this trend graphically. A...
View ArticleHow does provider network size influence health care utilization?
Are narrow networks a good thing? On the one hand, they may be able to reduce health insurance premiums if insurers can negotiate lower prices. On the other hand, narrow networks means less choice...
View ArticleThe growing influence of private equity in medicine
Physicians are increasingly becoming parts of larger and larger practice. Further, many physicians are shifting from firm owners to employees. In recent years, private equity investments have helped...
View ArticleOn the promise and peril of health systems
Integrated delivery networks. IDNs. Accountable Care Organizations. ACOs. Systems of care. Health systems. Whatever you call them, many health policy experts claim that they are the best way for the...
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The perils of health systems
Last week I reviewed an article on some of the potential positives and negatives of large, integrated health systems. A recent 60 Minutes episode talks about some of the perils by examining how Sutter...
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The rise of the health systems
Health systems have been touted by some to be a cure to many of our health care systems ills by providing integrated, high quality care. Others claim that health systems are just a way for providers...
View ArticlePaying for mental health care in the Netherlands
As COVID-19 has made many of us acutely aware, providing high quality mental health care is vital. However, the mental health care market is a difficult one for insurers; there is evidence that...
View ArticleWhat is the FTC’s stance on pharmaceutical mergers?
The answer to this question likely will be shaped in part by a new multilateral working group that will include not only representatives from the U.S. (U.S. Department of Justice Antitrust Division,...
View Article‘Big is beautiful’ when it comes to physician practices?
A book by Robert Atkinson and Michael Lind argued that big businesses–rather than small businesses–are the drivers of the economy. That book had the catchy title “Big is Beautiful“. A related question...
View ArticleBiden’s Executive Order on Promoting Competition in the American Economy:...
Last Friday, President Biden released an executive order titled “Promoting Competition in the American Economy” While the order talk about transportation, internet companies, and farming, there were a...
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CBO: Impact of price control legislation on new drug development
It stands to reason that policies that aim to reduce drug prices or squeeze life science companies profits are likely to decrease incentives to finance the research and development needed to bring a...
View ArticleImpact of hospital mergers on quality: a case study
There is mixed evidence about whether hospital mergers improve quality. On the one hand, economies of scale could lead to more investment in information technology, or allow for further specialization...
View ArticlePhysician Group Influences on Treatment Intensity
Over time, physicians are less likely to operate in solo or small group practices. In fact, the share of physician-owned practices has fallen below 50% in recent years. A key question then is how does...
View ArticleAre Integrated Medicare Advantage Plans better?
That is the question Park, Langellier, and Meyers (2022) aim to estimate in their recent Health Services Research publication. The authors use 2015-2017 data from the Centers for Medicare and Medicaid...
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