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Network Formation and Bargaining in Vertical Markets: The Case of Narrow Networks in Health Insurance

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  • Soheil Ghili

    (Yale University, New Haven, Connecticut 06520)

Abstract

This paper develops a model of vertical markets with multiple upstream and downstream firms. Networks of vertical relationships, negotiated contract terms for those relationships, and downstream prices charged to end customers all arise endogenously. In addition, I provide an estimation procedure to fully rationalize the observed network and contracts in a computationally scaleable manner. I empirically apply the framework to the market between hospitals and health insurers. I use the model to quantify the effects of “network adequacy regulations,” which are designed to broaden patients’ hospital choice sets but can backfire by increasing prices. I show that “tight” regulations have adverse effects. I also show market response is substantially impacted by complex mechanisms involving the interplay among multiple insurers and between upstream negotiation and downstream pricing.

Suggested Citation

  • Soheil Ghili, 2022. "Network Formation and Bargaining in Vertical Markets: The Case of Narrow Networks in Health Insurance," Marketing Science, INFORMS, vol. 41(3), pages 501-527, May.
    • Handle: RePEc:inm:ormksc:v:41:y:2022:i:3:p:501-527
    DOI: 10.1287/mksc.2021.1331
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    References listed on IDEAS

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    1. Capps, Cory & Dranove, David & Satterthwaite, Mark, 2003. "Competition and Market Power in Option Demand Markets," RAND Journal of Economics, The RAND Corporation, vol. 34(4), pages 737-763, Winter.
    2. Katherine Ho, 2006. "The welfare effects of restricted hospital choice in the US medical care market," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 21(7), pages 1039-1079.
    3. Kate Ho & Robin S. Lee, 2017. "Insurer Competition in Health Care Markets," Econometrica, Econometric Society, vol. 85, pages 379-417, March.
    4. Kate Ho & Robin S. Lee, 2019. "Equilibrium Provider Networks: Bargaining and Exclusion in Health Care Markets," American Economic Review, American Economic Association, vol. 109(2), pages 473-522, February.
    5. Andrea Prat & Aldo Rustichini, 2003. "Games Played Through Agents," Econometrica, Econometric Society, vol. 71(4), pages 989-1026, July.
    6. Schmitt, Matt, 2017. "Do hospital mergers reduce costs?," Journal of Health Economics, Elsevier, vol. 52(C), pages 74-94.
    7. Leslie M. Marx & Greg Shaffer, 2007. "Upfront payments and exclusion in downstream markets," RAND Journal of Economics, RAND Corporation, vol. 38(3), pages 823-843, September.
    8. Gautam Gowrisankaran & Aviv Nevo & Robert Town, 2015. "Mergers When Prices Are Negotiated: Evidence from the Hospital Industry," American Economic Review, American Economic Association, vol. 105(1), pages 172-203, January.
    9. Ilya Segal, 1999. "Contracting with Externalities," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 114(2), pages 337-388.
    10. Henrick Horn & Asher Wolinsky, 1988. "Bilateral Monopolies and Incentives for Merger," RAND Journal of Economics, The RAND Corporation, vol. 19(3), pages 408-419, Autumn.
    11. Abreu, Dilip & Manea, Mihai, 2012. "Bargaining and efficiency in networks," Journal of Economic Theory, Elsevier, vol. 147(1), pages 43-70.
    12. Stole, Lars A & Zwiebel, Jeffrey, 1996. "Organizational Design and Technology Choice under Intrafirm Bargaining," American Economic Review, American Economic Association, vol. 86(1), pages 195-222, March.
    13. Lars A. Stole & Jeffrey Zwiebel, 1996. "Intra-firm Bargaining under Non-binding Contracts," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 63(3), pages 375-410.
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    2. Chambolle, Claire & Christin, Clémence & Molina, Hugo, 2023. "Buyer power and exclusion: A progress report," International Journal of Industrial Organization, Elsevier, vol. 90(C).

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