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Gowrisankaran G & Town R, (2003)
‘Competition, Payers and Hospital Quality’
Health Services Research 38, pp. 1403–1421
- Estimates the effects of competition for both Medicare and HMO patients
on the quality decisions of hospitals in Southern California.
- Investigates
whether increased competition among hospitals affects health outcomes
for pneumonia and acute myocardial infarction (AMI) patients.
Key results:
- The estimates indicate that increasing competition for HMO patients
appears to reduce prices and save lives and hence appears to improve
welfare.
- However, increases in competition for Medicare patients
appear to reduce quality and may reduce welfare.
- Increasing competition
has little net effect on hospital quality in their sample (the HMO
and Medicare effects cancel each other out).
- Based on these results
the authors argue that the impact of competition on quality depends
on hospital’s control over reimbursement
rates. If the reimbursement rates are too low, hospitals may not have
an incentive to compete for Medicare patients through better quality.
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