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Mergers and Exclusionary Practices in Health Care Markets

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Esther Gal-Or

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Abstract

We evaluate the relationship between insurers (payers) and providers of health care (hospitals) when they each have a nonnegligible share of the market. We focus in particular on their incentives to merge and the existence of equilibria where payers offer preferential treatment to a subset of hospitals. We demonstrate that hospitals are more likely to merge without consolidating their capacities the less competitive they are vis-à-vis the payer's market. Payers are more likely to merge without consolidating their capacities the less competitive either the hospitals' or the payers' market is. A given payer follows an exclusionary strategy when its starting bargaining position vis-à-vis hospitals is weak. At such exclusionary equilibria, payers tend to distinguish themselves from neighboring payers by contracting with a different subset of hospitals. Copyright (c) 1999 Massachusetts Institute of Technology.

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Article provided by Blackwell Publishing in its journal Journal of Economics & Management Strategy.

Volume (Year): 8 (1999)
Issue (Month): 3 (09)
Pages: 315-350
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Handle: RePEc:bla:jemstr:v:8:y:1999:i:3:p:315-350

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  1. Karen Eggleston & George Norman & Lynne Pepall, 2002. "Managed Health Care and Provider Integration: a Theory of Bilateral Market Power," Discussion Papers Series, Department of Economics, Tufts University 0204, Department of Economics, Tufts University. [Downloadable!]
  2. David Bardey & Jean-Charles Rochet, 2009. "Competition among Health Plans: A Two-Sided Market Approach," DOCUMENTOS DE TRABAJO 005217, UNIVERSIDAD DEL ROSARIO - FACULTAD DE ECONOMÍA. [Downloadable!]
  3. Katherine Ho, 2005. "Insurer-Provider Networks in the Medical Care Market," NBER Working Papers 11822, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  4. Martin Gaynor & Deborah Haas-Wilson, 1998. "Change, Consolidation, and Competition in Health Care Markets," HEW 9809001, EconWPA. [Downloadable!]
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  5. repec:mop:credwp:04.05.45 is not listed on IDEAS
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  6. Mark Dusheiko & Maria Goddard & Hugh Gravelle & Rowena Jacobs, 2008. "Explaining trends in concentration of healthcare commissioning in the English NHS," Health Economics, John Wiley & Sons, Ltd., vol. 17(8), pages 907-926. [Downloadable!]
  7. Suchan Chae & Paul Heidhues, 2003. "Buyers’ Alliances for Bargaining Power," CIG Working Papers SP II 2003-24, Wissenschaftszentrum Berlin (WZB), Research Unit: Competition and Innovation (CIG). [Downloadable!]
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