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Geographic markets in hospital mergers: a case study

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Author Info
John Simpson
Abstract

In three recent hospital merger cases, the courts concluded that the merged hospital would be unable to increase price profitably because of competition from distant hospitals. In reaching this conclusion, the courts found the following: hospitals earn high margins on the last patients that they serve; given these high margins, a small price increase would be unprofitable if even a relatively small percentage of patients switched to other hospitals; many of the merging hospitals' patients live in 'contestable' zip codes, where a large percentage of patients already use other hospitals; a price increase at the merging hospitals would prompt a large number of these patients to switch to other hospitals; and this amount of switching would make the price increase unprofitable. This article argues that the courts in these cases erred in accepting the defendants' argument that switching by patients living in 'contestable' zip codes would make a price increase at the merging hospitals unprofitable. Specifically, this article examines the behavior of patients following a merger similar to those analyzed by these courts and finds that a large price increase prompted little switching by patients living in 'contestable' zip codes.

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Publisher Info
Article provided by Taylor and Francis Journals in its journal International Journal of the Economics of Business.

Volume (Year): 10 (2003)
Issue (Month): 3 (November)
Pages: 291-303
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Handle: RePEc:taf:ijecbs:v:10:y:2003:i:3:p:291-303

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Related research
Keywords: Hospital Mergers; Geographic Markets;

References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

  1. Vita, Michael G & Sacher, Seth, 2001. "The Competitive Effects of Not-for-Profit Hospital Mergers: A Case Study," Journal of Industrial Economics, Blackwell Publishing, vol. 49(1), pages 63-84, March. [Downloadable!] (restricted)
  2. Cory S. Capps & David Dranove & Shane Greenstein & Mark Satterthwaite, 2001. "The Silent Majority Fallacy of the Elzinga-Hogarty Criteria: A Critique and New Approach to Analyzing Hospital Mergers," NBER Working Papers 8216, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  3. Simpson, John, 1995. "A note on entry by small hospitals," Journal of Health Economics, Elsevier, vol. 14(1), pages 107-113, May. [Downloadable!] (restricted)
  4. Danger, K. & Frech, H.E.III., 2001. "Critical Thinking about "Critical Loss" in Antitrust," Papers 01-4, U.S. Department of Justice - Antitrust Division.
  5. Ted Frech, 1998. "Managed Care, Distance Traveled, and Hospital Market Definition," University of California at Santa Barbara, Economics Working Paper Series 13-98, Department of Economics, UC Santa Barbara. [Downloadable!]
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This page was last updated on 2009-11-25.


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