Vertical integration: Hospital ownership of physician practices is associated with higher prices and spending

Health Affairs

Volumn 34, Issue 5, 2014, Pages 756-763

  Baker, Laurence C ^a,b   Kate Bundorf, M ^a,b   Kessler, Daniel P ^a,b  

^a STANFORD UNIVERSITY   (United States)

^b NATIONAL BUREAU OF ECONOMIC RESEARCH   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CONTROLLED STUDY; HEALTH CARE COST; HEALTH CARE PERSONNEL; HEALTH CARE QUALITY; HOSPITAL; HOSPITAL ADMISSION; HOSPITAL COST; HOSPITAL MANAGEMENT; HOSPITAL ORGANIZATION; HOSPITAL PHYSICIAN; HOSPITAL SERVICE; HUMAN; INTEGRATION; MARKET; MEDICAL FEE; MEDICAL INFORMATION; MEDICAL PRACTICE; MEDICAL SOCIETY; PATIENT REFERRAL; PHYSICIAN; PRIVATE HEALTH INSURANCE; VERTICAL INTEGRATION; COST BENEFIT ANALYSIS; ECONOMICS; FINANCIAL MANAGEMENT; FRAUD; HEALTH CARE DELIVERY; HOSPITAL CHARGE; ORGANIZATION AND MANAGEMENT; UNITED STATES;

CONTRACT SERVICES; COST-BENEFIT ANALYSIS; DELIVERY OF HEALTH CARE; FRAUD; HEALTH CARE COSTS; HOSPITAL CHARGES; HOSPITAL COSTS; HOSPITAL-PHYSICIAN JOINT VENTURES; HUMANS; OWNERSHIP; UNITED STATES;

EID: 84899886627     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2013.1279     Document Type: Article

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19. To access the Appendix, click on the Appendix link in the box to the right of the article online.
20. As Appendix Table 1 shows (see Note 19), we had data on vertical integration and other market and area characteristics for 2,454 of the approximately 3,100 US counties with residential population. It also shows that although the MarketScan data only cover one-quarter to onefifth of all US counties, the counties they cover include most of the US population and are broadly representative of the United States as a whole.
21. We also estimated the model underlying Exhibit 3 using enrollee-level data with standard errors clustered at the county-year level. The estimated effects of fully integrated organizations and hospital market competitiveness were of similar magnitudes and statistically significant (p < 0:01). Estimates of the effects of the other three forms of integration remained small and insignificant.
22. We also estimated the model underlying Exhibit 4 using enrollee-level data with standard errors clustered at the county-year level. The estimated effects of open physicianhospital organizations was of a similar magnitude and statistically significant (p < 0:05). Estimates of the effects of the other three forms of integration and hospital market competitiveness remained small and insignificant.
23. This calculation is based on the coefficients and standard errors shown in Appendix Table 2 and the standard deviation of the market share of fully integrated organizations in Appendix Table 1 (see Note 19).