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Endogenous Quality Investments in the U.S. Hospital Market

Author

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  • Craig Garthwaite
  • Christopher Ody
  • Amanda Starc

Abstract

High and increasing hospital prices have led to calls for price regulation. If prices are high because of consolidation, regulating prices could enhance welfare. However, high prices could also reflect increased willingness to pay by privately insured consumers for clinical and non-clinical quality. If so, regulating prices could reduce quality. We present a model of strategic quality choice where hospitals make quality investments to increase private revenue. We confirm the model's predictions across numerous quality measures including patient satisfaction, hospital processes, risk adjusted mortality, the revealed preferences of current Medicare patients, technology adoption, physician quality, and ED wait times.

Suggested Citation

  • Craig Garthwaite & Christopher Ody & Amanda Starc, 2020. "Endogenous Quality Investments in the U.S. Hospital Market," NBER Working Papers 27440, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:27440
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    References listed on IDEAS

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    Cited by:

    1. Martin Gaynor & Kate Ho & Robert J. Town, 2015. "The Industrial Organization of Health-Care Markets," Journal of Economic Literature, American Economic Association, vol. 53(2), pages 235-284, June.
    2. Johannes S. Kunz & Carol Propper & Kevin E. Staub & Rainer Winkelmann, 2023. "Assessing the Quality of Public Services: For-profits, Chains, and Concentration in the Hospital Market," Papers 2023-01, Centre for Health Economics, Monash University.
    3. Propper, Carol & Kunz, Johannes, 2022. "Is Hospital Quality Predictive of Pandemic Deaths? Evidence from US Counties," CEPR Discussion Papers 17365, C.E.P.R. Discussion Papers.
    4. Kunz, Johannes S. & Propper, Carol, 2023. "JUE Insight: Is hospital quality predictive of pandemic deaths? Evidence from US counties," Journal of Urban Economics, Elsevier, vol. 133(C).

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    JEL classification:

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

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