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The effect of non-rural hospital mergers and acquisitions: An examination of cost and price outcomes

  • Spang, Heather Radach
  • Arnould, Richard J.
  • Bazzoli, Gloria J.
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    This paper examines the direct impact of urban horizontal hospital consolidations on hospital efficiency and prices. Specifically, we measure the extent of cost savings resulting from these consolidations and the extent to which these gains are passed on to consumers. A fixed effects model is tested with data consisting of 4160 unique hospitals, 125 of which were involved in mergers and 1040 in system acquisitions, for over a 10-year time period. We find that hospital consolidation may generate efficiency in some circumstances and some of these gains may be passed on to consumers, but the results are very sensitive to hospital ownership and governance and the structure of the market following the consolidation.

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    File URL: http://www.sciencedirect.com/science/article/B6W5X-4N4J33R-1/2/a81acbf4c847f4987f532f7889e9dca3
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    Article provided by Elsevier in its journal The Quarterly Review of Economics and Finance.

    Volume (Year): 49 (2009)
    Issue (Month): 2 (May)
    Pages: 323-342

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    Handle: RePEc:eee:quaeco:v:49:y:2009:i:2:p:323-342
    Contact details of provider: Web page: http://www.elsevier.com/locate/inca/620167

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    1. Dranove, David & Cone, Kenneth, 1985. "Do state rate setting regulations really lower hospital expenses?," Journal of Health Economics, Elsevier, vol. 4(2), pages 159-165, June.
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    8. Melnick, Glenn A. & Zwanziger, Jack & Bamezai, Anil & Pattison, Robert, 1992. "The effects of market structure and bargaining position on hospital prices," Journal of Health Economics, Elsevier, vol. 11(3), pages 217-233, October.
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    11. Martin Gaynor & Deborah Haas-Wilson, 1998. "Change, Consolidation, and Competition in Health Care Markets," NBER Working Papers 6701, National Bureau of Economic Research, Inc.
    12. Keeler, Emmett B. & Melnick, Glenn & Zwanziger, Jack, 1999. "The changing effects of competition on non-profit and for-profit hospital pricing behavior," Journal of Health Economics, Elsevier, vol. 18(1), pages 69-86, January.
    13. Dranove, David, 1998. "Economies of scale in non-revenue producing cost centers: Implications for hospital mergers," Journal of Health Economics, Elsevier, vol. 17(1), pages 69-83, January.
    14. White, Halbert, 1980. "A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for Heteroskedasticity," Econometrica, Econometric Society, vol. 48(4), pages 817-38, May.
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