Health Care Markets Managed Care and Hospital Performance

摘要

This project consists of multiple studies that examine the interaction among health care markets, managed care, and hospital performance in California and the US between 1989 and 1997. In our national study, hospitals in high managed care penetration areas display a significantly lower rate of cost growth but the ability of managed care plans to slow cost growth is dependent upon the level of hospital competition. The authors' research also provides suggestive evidence that greater levels of managed care penetration are associated with lower levels of uncompensated care delivery, controlling for hospital market structure. In California, the authors find that increased hospital competition reduced the rate of growth in hospital costs and revenues over a significantly longer time period than demonstrated in previous studies. The authors' examination on the effects of changing market structure on pricing behavior of non-profit and for-profit hospitals shows that non-profit and government hospitals have steadily become more willing to raise prices to exploit market power, which raises issues for antitrust regulators.