Concentration in orthopedic markets was associated with a 7 percent increase in physician fees for total knee replacements

Health Affairs

Volumn 34, Issue 6, 2015, Pages 916-921

  Sun, Eric ^a   Baker, Laurence C ^a,b  

^a STANFORD UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b NATIONAL BUREAU OF ECONOMIC RESEARCH   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; HUMAN; KNEE ARTHRITIS; KNEE ARTHROPLASTY; KNEE PROSTHESIS; LENGTH OF STAY; MARKET; MEDICAL FEE; ORTHOPEDIC SURGERY; SENSITIVITY ANALYSIS; TOTAL KNEE REPLACEMENT; ECONOMICS; HEALTH CARE COST; HEALTH CARE POLICY; KNEE REPLACEMENT; MANAGEMENT; ORTHOPEDICS; UNITED STATES;

ARTHROPLASTY, REPLACEMENT, KNEE; FEES, MEDICAL; HEALTH EXPENDITURES; HUMANS; ORTHOPEDICS; PATIENT PROTECTION AND AFFORDABLE CARE ACT; PRACTICE MANAGEMENT; UNITED STATES;

EID: 84930892524     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2014.1325     Document Type: Article

References (30)

1. Dafny L, Duggan M, Ramanarayanan S. Paying a premium on your premium? Consolidaiton in the US healthcare industry. Am Econ Rev. 2012;102(2):1161-85.
2. Defelice LC, Bradford WD. Relative inefficiencies in production between solo and group practice physicians. Health Econ. 1997;6(5):455-65.
3. Walston SL, Kimberly JR, Burns LR. Owned vertical integration and health care: promise and performance. Health Care Manage Rev. 1996;21(1):83-92.
4. Ketcham JD, Baker LC, MacIsaac D. Physician practice size and variations in treatments and outcomes: evidence from Medicare patients with AMI. Health Aff (Millwood). 2007;26(1):195-205.
5. Weeks WB, Gottlieb DJ, Nyweide DE, Sutherland JM, Bynum J, Casalino LP, et al. Higher health care quality and bigger savings found at large multispecialty medical groups. Health Aff (Millwood). 2009;29(5): 991-7. Erratum in: Health Aff (Millwood). 2010;29(6):1275.
6. Gaynor M, Town RJ. Competition in health care markets. In: Pauly MV, McGuire TG, Barros PP, editors. Handbook of health economics. Vol. 2. Amsterdam: North Holland 2012. p. 499-637.
7. Ho K. Insurer-provider networks in the medical care market. Am Econ Rev. 2009;99(1):393-430.
8. Berenson RA, Ginsburg PB, Kemper N. Unchecked provider clout in California foreshadows challenges to health reform. Health Aff (Millwood). 2010;29(4):699-705.
9. Dranove D, Simon CJ, White WD. Is managed care leading to consolidation in health-care markets? Health Serv Res. 2002;37(3):573-94.
10. Kocher R, Sahni NR. Hospitals' race to employ physicians-the logic behind a money-losing proposition. N Engl J Med. 2011;364(19):1790-3.
11. Gaynor M, Haas-Wilson D. Change, consolidation, and competition in health care markets. J Econ Perspect. 1999;13(1):141-64.
12. Casalino LP. The Federal Trade Commission, clinical integration, and the organization of physician practice. J Health Polit Policy Law. 2006;31(3):569-85.
13. Casalino LP, Devers KJ, Lake TK, Reed M, Stoddard JJ. Benefits of and barriers to large medical group practice in the United States. Arch Intern Med. 2003;163(16):1958-64.
14. Ginsburg PB.Wide variation in hospital and physician payment rates evidence of provider market power [Internet]. Washington (DC): Center for Studying Health System Change 2010 Nov [cited 2015 Mar 27]. (HSC Research Brief No 16). Available from: http://www.hschange.com/ CONTENT/1162/1162.pdf
15. Baker LC, Bundorf MK, Royalty AB, Levin Z. Physician practice competition and prices paid by private insurers for office visits. JAMA. 2014; 312(16):1653-62.
16. Muñoz E, Muñoz W 3rd, Wise L. National and surgical health care expenditures, 2005-2025. Ann Surg. 2010;251(2):195-200.
17. Laugesen MJ, Glied SA. Higher fees paid to US physicians drive higher spending for physician services compared to other countries. Health Aff (Millwood). 2011;30(9):1647-56.
18. Cram P, Lu X, Kates SL, Singh JA, Li Y, Wolf BR. Total knee arthroplasty volume, utilization, and outcomes among Medicare beneficiaries, 1991- 2010. JAMA. 2012;308(12):1227-36.
19. Baker L, Bundorf MK, Royalty A. Private insurers' payments for routine physician office visits vary substantially across the United States. Health Aff (Millwood). 2013;32(9): 1583-90.
20. Chernew ME, Sabik LM, Chandra A, Gibson TB, Newhouse JP. Geographic correlation between largefirm commercial spending and Medicare spending. Am J Manag Care. 2010;16(2):131-8.
21. Dor A, Koroukian S, Xu F, Stulberg J, Delaney C, Cooper G. Pricing of surgeries for colon cancer: patient severity and market factors. Cancer. 2012;118(23):5741-8.
22. Dunn A, Liebman E, Pack S, Shapiro AH. Medical care price indexes for patients with employer-provided insurance: nationally representative estimates from MarketScan data. Health Serv Res. 2013;48(3): 1173-90.
23. To access the Appendix, click on the Appendix link in the box to the right of the article online.
24. Welch WP, Cuellar AE, Stearns SC, Bindman AB. Proportion of physicians in large group practices continued to grow in 2009-11. Health Aff (Millwood). 2013;32(9): 1659-66.
25. Pham HH, Schrag D, O'Malley AS, Wu B, Bach PB. Care patterns in Medicare and their implications for pay for performance. N Engl J Med. 2007;356(11):1130-9.
26. Hervey SL, Purves HR, Guller U, Toth AP, Vail TP, Pietrobon R. Provider volume of total knee arthroplasties and patient outcomes in the HCUP-Nationwide Inpatient Sample. J Bone Joint Surg Am. 2003;85-A(9): 1775-83.
27. Jena AB, Sun E, Goldman DP. Confounding in the association of proton pump inhibitor use with risk of community-acquired pneumonia. J Gen Intern Med. 2013;28(2): 223-30.
28. Prasad V, Jena AB. Prespecified falsification end points: can they validate true observational associations? JAMA. 2013;309(3):241-2.
29. Department of Justice and Federal Trade Commission. Horizontal merger guidelines [Internet]. Washington (DC): DOJ; 2010 Aug 19 [cited 2015 Apr 7]. Available from: http://www.justice.gov/atr/public/ guidelines/hmg-2010.html#5c
30. Nordt JC, Connair MP, Gregorian JA. As Medicare costs rise, reimbursements drop [Internet]. Rosemont (IL): American Academy of Orthopaedic Surgeons; [cited 2015 Mar 27]. Available from: http://www .aaos.org/news/aaosnow/dec12/ cover1.asp