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Managed Care, Consolidation Among Health Care Providers, and Health Care: Evidence from Mammography

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  • Laurence C. Baker
  • Martin L. Brown
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    Abstract

    We discuss the effects of managed care on the structure of the health care delivery system, focusing on managed-care-induced consolidation among health care providers. We empirically investigate the relationship between HMO market share and mammography providers. We find evidence of consolidation: increases in HMO activity are associated with reductions in the number of mammography providers and with increases in the number of services produced by remaining providers. We also find that increases in HMO market share are associated with reductions in costs for mammography and with increases in waiting times for appointments, but not with worse health outcomes.

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    Bibliographic Info

    Article provided by The RAND Corporation in its journal RAND Journal of Economics.

    Volume (Year): 30 (1999)
    Issue (Month): 2 (Summer)
    Pages: 351-374

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    Handle: RePEc:rje:randje:v:30:y:1999:i:summer:p:351-374

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    Cited by:
    1. Robert Town & Douglas Wholey & Roger Feldman & Lawton R. Burns, 2005. "Did the HMO Revolution Cause Hospital Consolidation?," NBER Working Papers 11087, National Bureau of Economic Research, Inc.
    2. Bokhari, Farasat A.S., 2009. "Managed care competition and the adoption of hospital technology: The case of cardiac catheterization," International Journal of Industrial Organization, Elsevier, Elsevier, vol. 27(2), pages 223-237, March.
    3. Finocchiaro Castro, Massimo & Guccio, Calogero & Pignataro, Giacomo & Rizzo, Ilde, 2014. "The effects of reimbursement mechanisms on medical technology diffusion in the hospital sector in the Italian NHS," Health Policy, Elsevier, Elsevier, vol. 115(2), pages 215-229.
    4. Huckman, Robert S., 2006. "Hospital integration and vertical consolidation: An analysis of acquisitions in New York State," Journal of Health Economics, Elsevier, Elsevier, vol. 25(1), pages 58-80, January.
    5. Yavuz Yasar, 2005. "Screening For Cancer And Market Structure:A Multilevel Analysis For Mammogram And Pap-Smear Utilization In The U.S," HEW, EconWPA 0503002, EconWPA.
    6. Martin Gaynor & Robert J. Town, 2011. "Competition in Health Care Markets," NBER Working Papers 17208, National Bureau of Economic Research, Inc.
    7. Baker, Laurence C., 2001. "Managed care and technology adoption in health care: evidence from magnetic resonance imaging," Journal of Health Economics, Elsevier, Elsevier, vol. 20(3), pages 395-421, May.
    8. Bourgeon, Jean-Marc & Picard, Pierre & Pouyet, Jerome, 2008. "Providers' affiliation, insurance and collusion," Journal of Banking & Finance, Elsevier, Elsevier, vol. 32(1), pages 170-186, January.
    9. Croxson, Bronwyn & Propper, Carol & Shearer, Arran, 2000. "Waiting Times for Hospital Admissions: the Impact of GP Fundholding," CEPR Discussion Papers, C.E.P.R. Discussion Papers 2489, C.E.P.R. Discussion Papers.

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