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Mergers and marginal costs: New evidence on hospital buyer power

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  • Stuart V. Craig
  • Matthew Grennan
  • Ashley Swanson

Abstract

We estimate the effects of hospital mergers, using detailed data containing medical supply transactions (representing 23% of operating costs) from a sample of US hospitals, 2009–2015. Pre‐merger price variation across hospitals (Gini coefficient 7%) suggests significant opportunities for cost decreases. However, we observe limited evidence of actual savings. In this retrospective study, targets realized 1.9% savings; acquirers realized no significant savings. Examining treatment effect heterogeneity to shed light on theories of “buyer power,” we find that savings, when they occur, tend to be local, and potential benefits of savings may be offset by managerial costs of merging.

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  • Stuart V. Craig & Matthew Grennan & Ashley Swanson, 2021. "Mergers and marginal costs: New evidence on hospital buyer power," RAND Journal of Economics, RAND Corporation, vol. 52(1), pages 151-178, March.
    • Handle: RePEc:bla:randje:v:52:y:2021:i:1:p:151-178
    DOI: 10.1111/1756-2171.12365
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    Cited by:

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    2. Ralph B. Siebert, 2022. "What Determines Heterogeneous Merger Effects on Competitive Outcomes?," Journal of Industrial Economics, Wiley Blackwell, vol. 70(1), pages 217-256, March.
    3. Luan, Mengna & Tao, Zhigang & Yuan, Hongjie, 2023. "Monopsony power and workers’ switching costs: Evidence from hospitals in China," Economics Letters, Elsevier, vol. 233(C).
    4. Javier Donna & Andre Trindade & Pedro Pereira & Tiago Pires, 2018. "Measuring the Welfare of Intermediation in Vertical Markets," 2018 Meeting Papers 984, Society for Economic Dynamics.
    5. Donna, Javier D. & Pereira, Pedro & Pires, Tiago & Trindade, Andre, 2018. "Measuring the Welfare of Intermediaries in Vertical Markets," MPRA Paper 90465, University Library of Munich, Germany.
    6. Ivan Badinski & Amy Finkelstein & Matthew Gentzkow & Peter Hull, 2023. "Geographic Variation in Healthcare Utilization: The Role of Physicians," NBER Working Papers 31749, National Bureau of Economic Research, Inc.
    7. Bisceglia, Michele & Padilla, Jorge & Piccolo, Salvatore & Sääskilahti, Pekka, 2023. "On the bright side of market concentration in a mixed-oligopoly healthcare industry," Journal of Health Economics, Elsevier, vol. 90(C).
    8. Johannes S. Kunz & Carol Propper & Kevin E. Staub & Rainer Winkelmann, 2023. "Assessing the Quality of Public Services: For-profits, Chains, and Concentration in the Hospital Market," Papers 2023-01, Centre for Health Economics, Monash University.
    9. Stephen McCarthy & Damien Sheehan‐Connor, 2022. "The effect of hospital‐physician integration on hospital costs," Health Economics, John Wiley & Sons, Ltd., vol. 31(11), pages 2333-2368, November.
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    11. Johannes S. Kunz & Carol Propper & Kevin E. Staub & Rainer Winkelmann, 2024. "Assessing the quality of public services: For‐profits, chains, and concentration in the hospital market," Health Economics, John Wiley & Sons, Ltd., vol. 33(9), pages 2162-2181, September.

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    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • L40 - Industrial Organization - - Antitrust Issues and Policies - - - General

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