Unbiased Analysis of Today's Healthcare Issues
That is the question posted by a recent paper by Li and Dor (2024). However, they define competition not just by the number of community health center (CHC) competitors or market concentration (e.g., Herfindahl-Hirschman Index, HHI) but also the quality of care provided by their competitors. A key methodological question is how this should be…
As of 2007, about half of physicians had noncompete clauses (“noncompetes” for short) in their contracts. However, a recent FTC rule severely limits when they could be used. What specifically did the new FTC rule say about non-competes? Fuse Brown et al. (2024) provide a helpful summary. The final FTC rule declares all new noncompete clauses or…
There is even less competition then we may have thought according to a paper out this month by Socal et al. (2023): We identified a total of 565 facilities producing 1,379 unique generic APIs across forty-two countries. India, China, and Italy were the top producers; 14 percent of APIs were manufactured in the US. About a…
HHS has a policy paper titled “Reforming America’s Healthcare System Through Choice and Competition“. In the paper, HHS describes four broad areas of reform. I describe each in term, some of the key policy recommendation under each of the four headings, and my thoughts on each reform. Here goes: Health care workforce and labor markets.…
Yesterday, I discussed the idea of managed competition in California. One of the original tenets of managed competition was insurers having integrated, mutually exclusive provider networks. This would mean much more consolidation on the provider side. While this could improve quality, there is also a risk that prices could rise. In fact, this is what…
Competition matters for markets…even health care markets. A paper by Van Parys (2018) relies on a database of plan premium and market characteristics among states with federally-facilitated health insurance exchange Marketplaces. In this analysis, she finds that: In 2018, Marketplace premiums were 50 percent ($180) higher, on average, in rating areas with monopolist insurers, compared…
Likely not. At least according to some research by William Vogt. In an NIHCM Issue Brief, Dr. Vogt states: The inpatient hospital market in the United States was transformed by a wave of hospital consolidation during the 1990s, which witnessed more than 900 mergers and acquisitions. Many cities came to be dominated by two or three large hospital systems, and…
For the most part, the answer is “Yes” according to a recent study by Jung and Polsky. The authors use a Herfindahl index to measure competition and examine how outcomes for home health patients vary based on the level of competition. The (unadjusted) figures–based on data from OASIS— show that quality increases as competitions increases…
From the Commonwealth Fund: “The analysis says people have many plans to choose from but that enrollment is concentrated in a handful. It notes, for example, that the average Medicare beneficiary in 2010 has 33 plans from which to choose. But in 14 states and the District of Columbia, a single company (not the same…
The answer: sometimes. A study by Dafny (2009) finds that in markets with ten or more insurers, markets do seem to be competitive. However, with six or less insurers, health insurers do have some market power due to switching costs. “Using data on ‘fully insured’ health plans offered to employees of 184 publicly-held firms in…