How do health insurer market concentration and bargaining power with hospitals affect health insurance premiums?

Journal of Health Economics

Volumn 42, Issue , 2015, Pages 104-114

  Trish, Erin E ^a,b   Herring, Bradley J ^c  

^a UNIVERSITY OF SOUTHERN CALIFORNIA   (United States)

^b UNIVERSITY OF CALIFORNIA   (United States)

^c JOHNS HOPKINS BLOOMBERG SCHOOL OF PUBLIC HEALTH   (United States)

Author keywords

Bargaining power; Competition; Hospitals; Insurance; Premiums

Indexed keywords

HEALTH INSURANCE; HOSPITAL SECTOR; INDUSTRIAL COMPETITION; INSURANCE INDUSTRY; MARKET CONDITIONS; PROFITABILITY;

ARTICLE; CONTROLLED STUDY; HEALTH CARE DELIVERY; HEALTH CARE PLANNING; HEALTH CARE POLICY; HEALTH INSURANCE; HEALTH SERVICE; HOSPITAL ORGANIZATION; HOSPITAL PERSONNEL; HUMAN; MANAGED CARE ORGANIZATION; ECONOMIC ASPECT; ECONOMICS; EMPIRICAL RESEARCH; HOSPITAL; INTERPERSONAL COMMUNICATION; QUESTIONNAIRE;

UNITED STATES;

ECONOMIC COMPETITION; EMPIRICAL RESEARCH; HOSPITALS; INSURANCE, HEALTH; NEGOTIATING; SURVEYS AND QUESTIONNAIRES;

EID: 84928167077     PISSN: 01676296     EISSN: 18791646     Source Type: Journal    
DOI: 10.1016/j.jhealeco.2015.03.009     Document Type: Article

References (37)

1. American Medical Association Competition in Health Insurance. A Comprehensive Study of US Markets: 2013 Update 2013.
2. Berenson R., Ginsburg P., Christianson J., Yee T. The growing power of some providers to win steep payment increases from insurers suggests policy remedies may be needed. Health Affairs (Millwood) 2012, 31(5):973-981.
3. Capps C., Dranove D., Satterthwaite M. Competition and market power in option demand markets. RAND Journal of Economics 2003, 34(4):737-763.
4. Council for Affordable Health Insurance Health Insurance Mandates in the States 2006-11 2006-2011, The Council for Affordable Health Insurance.
5. Cox C., Ma R., Claxton G., Levitt L. Sizing Up Exchange Market Competition 2014, Kaiser Family Foundation Issue Brief.
6. Cutler D.M., Scott Morton F. Hospitals, market share, and consolidation. Journal of the American Medical Association 2013, 310(18):1964-1970.
7. Dafny L. Are health insurance markets competitive?. American Economic Review 2010, 100(4):1399-1431.
8. Dafny L., Dranove D., Limbrock F., Morton F.S. Data impediments to empirical work on health insurance markets. The B.E. Journal of Economic Analysis & Policy 2011, 11(2). Article 8.
9. Dafny L., Duggan M., Ramanarayanan S. Paying a premium on your premium? Consolidation in the US Health Insurance Industry. American Economic Review 2012, 102(2):1161-1185.
10. Dafny L., Gruber J., Ody C. More insurers lower premiums: evidence from initial pricing in the health insurance marketplaces. American Journal of Health Economics 2015, 1(1):53-81.
11. Dartmouth Atlas of Health Care Data by Region 2012, Available from: http://www.dartmouthatlas.org/data/region/.
12. Dranove D., Gron A., Mazzeo M. Differentiation and competition in HMO markets. Journal of Industrial Economics 2003, 51(4):433-454.
13. Dunn A., Shapiro A. Physician Market Power and Medical-Care Expenditures 2012, BEA Working Papers 0084, Bureau of Economic Analysis.
14. Dunn A., Shapiro A. The Impact of Health Care Reform on Physician Payments: Evidence from Massachusetts 2013, Working Paper 2013-36, Federal Reserve Bank of San Francisco.
15. Gaynor M., Town R. Competition in health care markets. Handbook of Health Economics 2011, vol. 2:499-637. Elsevier, Amsterdam.
16. Gaynor M., Town R. The Impact of Hospital Consolidation - Update 2012, June, Robert Wood Johnson Foundation Synthesis Report.
17. Gaynor M., Vogt W. Antitrust and competition in health care markets. Handbook of Health Economics 2000, vol. 1B:1405-1487. Elsevier, Amsterdam.
18. Ginsburg P. Wide Variation in Hospital and Physician Payment Rates Evidence of Provider Market Power 2010, HSC Research Brief No. 16, Center for Studying Health System Change.
19. Government Accountability Office (GAO) Report to the Honorable Paul Ryan: House of Representatives: Federal Employees Health Benefits Program - Competition and Other Factors Linked to Wide Variation in Health Care Prices, Washington, DC 2005.
20. Ho K. Insurer-provider networks in the medical care market. American Economic Review 2009, 99(1):393-430.
21. Ho K., Lee R.S. Insurer Competition and Negotiated Hospital Prices 2013, NBER Working Paper #19401, National Bureau of Economic Research.
22. Lewis M.S., Pflum K.E. Diagnosing hospital system bargaining power in managed care networks. American Economic Journal: Economic Policy 2015, 7(1):243-274.
23. Massachusetts Attorney General Examination of Health Care Cost Trends and Cost Drivers 2010, Report for Annual Public Hearing, Office of Attorney General Martha Coakley, Boston, MA.
24. McKellar M.R., Naimer S., Landrum M.B., Gibson T.B., Chandra A., Chernew M. Insurer market structure and variation in commercial health care spending. Health Services Research 2013, (Epub ahead of print: 5 December 2013).
25. Medicare Payment Advisory Commission (MedPAC) Report to the Congress: Medicare Payment Policy, Washington, DC 2009.
26. Melnick G., Shen Y., Wu V. The increased concentration of health plan markets can benefit consumers through lower hospital prices. Health Affairs (Millwood) 2011, 30(9):1728-1732.
27. Moriya A., Vogt W., Gaynor M. Hospital prices and market structure in the hospital and insurance industries. Health Economics, Policy and Law 2010, 5:459-479.
28. Robinson J. Consolidation and the transformation of competition in health insurance. Health Affairs (Millwood) 2004, 23(6):11-24.
29. Scanlon D.P., Swaminathan S., Lee W., Chernew M. Does competition improve health care quality?. Health Services Research 2008, 43(6):1931-1951.
30. Schneider J., Li P., Klepser D., Peterson N., Brown T., Scheffler R. The effect of physician and health plan market concentration on prices in commercial health insurance markets. International Journal of Health Care Finance and Economics 2008, 8:13-26.
31. Starc A. Insurer pricing and consumer welfare: evidence from Medigap. RAND Journal of Economics 2014, 45(1):198-220.
32. Town R., Wholey D., Feldman R., Burns L. The welfare consequences of hospital mergers 2006, NBER Working Paper #12244, National Bureau of Economic Research.
33. Trish E., Herring B. Does Small Group Market Community Rating Affect Firm Self-Insurance? 2014, Working Paper.
34. US Department of Justice and the Federal Trade Commission Horizontal Merger Guidelines 2010, Available from: http://www.justice.gov/atr/public/guidelines/hmg-2010.pdf.
35. Vogt W.B., Town R. How has Hospital Consolidation Affected the Price and Quality of Hospital Care? 2006, Research Synthesis Report No. 9, Robert Wood Johnson Foundation.
36. White C., Bond A.M., Reschovsky J.D. High and Varying Prices for Privately Insured Patients Underscore Hospital Market Power 2013, HSC Research Brief No. 27, Center for Studying Health System Change.
37. Wholey D., Feldman R., Christianson J. The effect of market structure on HMO premiums. Journal of Health Economics 1995, 14:81-105.