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Managed Care Discounting: Evidence from the MarketScan Database

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  • Avi Dor
  • Siran M. Koroukian
  • Michael Grossman

Abstract

The paper examines price discounting by health maintenance organizations and preferred provider organizations in markets for hospital services. Our empirical analysis focuses on transaction prices for angioplasty, which is a relatively common procedure, with well defined 'product' characteristics. After controlling for patient and procedure heterogeneity and market power we find that on average prices for PPOs are 8% lower than fee-for-service plans, followed by point-of-service HMOs who capture a 24% discount. Our results are in general agreement with earlier work that shows that managed care discounts are 'real', after accounting for process of care.

Suggested Citation

  • Avi Dor & Siran M. Koroukian & Michael Grossman, 2004. "Managed Care Discounting: Evidence from the MarketScan Database," NBER Working Papers 10437, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:10437
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    Cited by:

    1. Berden, Carolien & Croes, R. & Kemp, R. & Mikkers, Misja & van der Noll, Rob & Shestalova, V. & Svitak, Jan, 2019. "Hospital Competition in the Netherlands : An Empirical Investigation," Discussion Paper 2019-008, Tilburg University, Tilburg Law and Economic Center.
    2. Michael A. Morrisey & Alice M. Rivlin & Richard P. Nathan & Mark A. Hall, 2017. "Five‐State Study of ACA Marketplace Competition: A Summary Report," Risk Management and Insurance Review, American Risk and Insurance Association, vol. 20(2), pages 153-172, September.
    3. Avi Dor & William Encinosa & Kathleen Carey, 2016. "Do Good Reports Mean Higher Prices? The Impact of Hospital Compare Ratings on Cardiac Pricing," NBER Working Papers 22858, National Bureau of Economic Research, Inc.
    4. David Bardey & Jean‐Charles Rochet, 2010. "Competition Among Health Plans: A Two‐Sided Market Approach," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 19(2), pages 435-451, June.
    5. Avi Dor & Partha Deb & Michael Grossman & Gregory Cooper & Siran Koroukian & Fang Xu, 2013. "Impact of Mortality-Based Performance Measures on Hospital Pricing: the Case of Colon Cancer Surgeries," NBER Working Papers 19447, National Bureau of Economic Research, Inc.

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    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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