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Low risk, high reward? Repeated competitive biddings with multiple winners in health care

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  • Visa Pitkänen

    (Social Insurance Institution of Finland)

  • Signe Jauhiainen

    (Social Insurance Institution of Finland)

  • Ismo Linnosmaa

    (University of Eastern Finland
    National Institute for Health and Welfare)

Abstract

We study physiotherapy providers’ prices in repeated competitive biddings where multiple providers are accepted in geographical districts. Historically, only very few districts have rejected any providers. We show that this practice increased prices and analyze the effects the risk of rejection has on prices. Our data are derived from three subsequent competitive biddings. The results show that rejecting at least one provider decreased prices by more than 5% in the next procurement round. The results also indicate that providers have learned to calculate their optimal bids, which has also increased prices. Further, we perform counterfactual policy analysis of a capacity-rule of acceptance. The analysis shows that implementing a systematic acceptance rule results in a trade-off between direct cost savings and service continuity at patients’ usual providers.

Suggested Citation

  • Visa Pitkänen & Signe Jauhiainen & Ismo Linnosmaa, 2020. "Low risk, high reward? Repeated competitive biddings with multiple winners in health care," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(4), pages 483-500, June.
    • Handle: RePEc:spr:eujhec:v:21:y:2020:i:4:d:10.1007_s10198-019-01143-1
    DOI: 10.1007/s10198-019-01143-1
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    1. Cookson, Richard & Laudicella, Mauro & Donni, Paolo Li, 2013. "Does hospital competition harm equity? Evidence from the English National Health Service," Journal of Health Economics, Elsevier, vol. 32(2), pages 410-422.
    2. Paul Klemperer, 2002. "What Really Matters in Auction Design," Journal of Economic Perspectives, American Economic Association, vol. 16(1), pages 169-189, Winter.
    3. Zack Cooper & Stuart V Craig & Martin Gaynor & John Van Reenen, 2019. "The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 134(1), pages 51-107.
    4. Zack Cooper & Stephen Gibbons & Simon Jones & Alistair McGuire, 2011. "Does Hospital Competition Save Lives? Evidence From The English NHS Patient Choice Reforms," Economic Journal, Royal Economic Society, vol. 121(554), pages 228-260, August.
    5. Varkevisser, Marco & van der Geest, Stéphanie A. & Schut, Frederik T., 2012. "Do patients choose hospitals with high quality ratings? Empirical evidence from the market for angioplasty in the Netherlands," Journal of Health Economics, Elsevier, vol. 31(2), pages 371-378.
    6. Higuera, Lucas & Carlin, Caroline S. & Dowd, Bryan, 2018. "Narrow provider networks and willingness to pay for continuity of care and network breadth," Journal of Health Economics, Elsevier, vol. 60(C), pages 90-97.
    7. Piia Pekola & Ismo Linnosmaa & Hennamari Mikkola, 2017. "Does Competition Have an Effect on Price and Quality in Physiotherapy?," Health Economics, John Wiley & Sons, Ltd., vol. 26(10), pages 1278-1290, October.
    8. Forder, Julien & Allan, Stephen, 2014. "The impact of competition on quality and prices in the English care homes market," Journal of Health Economics, Elsevier, vol. 34(C), pages 73-83.
    9. Marco Varkevisser & Stéphanie Geest & Frederik Schut, 2010. "Assessing hospital competition when prices don’t matter to patients: the use of time-elasticities," International Journal of Health Economics and Management, Springer, vol. 10(1), pages 43-60, March.
    10. Rita Santos & Hugh Gravelle & Carol Propper, 2017. "Does Quality Affect Patients’ Choice of Doctor? Evidence from England," Economic Journal, Royal Economic Society, vol. 127(600), pages 445-494, March.
    11. Brett Katzman & Kerry Anne McGeary, 2008. "Will Competitive Bidding Decrease Medicare Prices," Southern Economic Journal, John Wiley & Sons, vol. 74(3), pages 839-856, January.
    12. Skrzypacz, Andrzej & Hopenhayn, Hugo, 2004. "Tacit collusion in repeated auctions," Journal of Economic Theory, Elsevier, vol. 114(1), pages 153-169, January.
    13. Song, Zirui & Landrum, Mary Beth & Chernew, Michael E., 2013. "Competitive bidding in Medicare Advantage: Effect of benchmark changes on plan bids," Journal of Health Economics, Elsevier, vol. 32(6), pages 1301-1312.
    14. Tay, Abigail, 2003. "Assessing Competition in Hospital Care Markets: The Importance of Accounting for Quality Differentiation," RAND Journal of Economics, The RAND Corporation, vol. 34(4), pages 786-814, Winter.
    15. Vrangbaek, Karsten & Robertson, Ruth & Winblad, Ulrika & Van de Bovenkamp, Hester & Dixon, Anna, 2012. "Choice policies in Northern European health systems," Health Economics, Policy and Law, Cambridge University Press, vol. 7(1), pages 47-71, January.
    16. Pedro Pita Barros & Werner B. F. Brouwer & Sarah Thomson & Marco Varkevisser, 2016. "Competition among health care providers: helpful or harmful?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(3), pages 229-233, April.
    17. Anthony J. Culyer & Adam Wagstaff (ed.), 1996. "Reforming Health Care Systems," Books, Edward Elgar Publishing, number 945.
    18. 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.
    19. Town, Robert & Vistnes, Gregory, 2001. "Hospital competition in HMO networks," Journal of Health Economics, Elsevier, vol. 20(5), pages 733-753, September.
    20. Gutacker, Nils & Siciliani, Luigi & Moscelli, Giuseppe & Gravelle, Hugh, 2016. "Choice of hospital: Which type of quality matters?," Journal of Health Economics, Elsevier, vol. 50(C), pages 230-246.
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    Cited by:

    1. Visa Pitkänen & Ismo Linnosmaa, 2021. "Choice, quality and patients’ experience: evidence from a Finnish physiotherapy service," International Journal of Health Economics and Management, Springer, vol. 21(2), pages 229-245, June.
    2. Visa Pitkänen, 2022. "Competition and efficiency in repeated procurements: Lessons from the Finnish rehabilitation markets," Health Economics, John Wiley & Sons, Ltd., vol. 31(5), pages 820-835, May.

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    More about this item

    Keywords

    Health care; Competitive bidding; Competition; Choice modelling; Prices;
    All these keywords.

    JEL classification:

    • C57 - Mathematical and Quantitative Methods - - Econometric Modeling - - - Econometrics of Games and Auctions
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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