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Town R & Vistnes G, (2001)
‘Hospital Competition in HMO Networks’
Journal of Health Economics 20(4), pp. 733-53
- Empirical analysis of how hospitals compete in a selective contracting
environment, using data from two large Californian HMOs.
- Tests the hypothesis
that a hospital’s price is constrained by the
degree of substitutability between an HMO’s current hospital network
and its next best alternative network that excludes the hospital.
- Simulates
mergers between hospitals to investigate the effect on prices.
Key results:
- The authors’ hypothesis is confirmed: a hospital’s bargaining
power and thus its price, decrease when the HMO can readily turn to
alternative networks that exclude the hospital.
- Even in an urban
area such as Los Angeles with a high hospital density, there is
enough differentiation among hospitals to allow for some
exercise of market power.
- By simulating mergers in Los Angeles the
authors find that a significant number of those simulated mergers
lead to predicted price increases
of over 5%.
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