IDEAS home Printed from https://ideas.repec.org/a/kap/ijhcfe/v20y2020i2d10.1007_s10754-019-09274-x.html
   My bibliography  Save this article

Consolidation in the dental industry: a closer look at dental payers and providers

Author

Listed:
  • Kamyar Nasseh

    (American Dental Association)

  • John R. Bowblis

    (Miami University)

  • Marko Vujicic

    (American Dental Association)

  • Sean Shenghsiu Huang

    (Georgetown University)

Abstract

We examine the effect of commercial dental insurance concentration on the size of dental practices, the decision of dentists to own a practice, and the choice of dentists to work at a dental management service organization—a type of corporate group practice that has become more prevalent in the United States in recent years. Using 2013–2015 dentist-level data from the American Dental Association, county-level data on firms and employment from the United States Census, and commercial dental insurance market concentration data from FAIR Health®, we find a modest effect of dental insurance market concentration on the size of dental practices. We also find that a higher level of commercial dental insurance market concentration is associated with a dentist’s decision not to own a practice. There is inconclusive evidence that higher levels of dental insurance market concentration impact a dentist’s decision to affiliate with a dental management service organization. Overall, our findings imply that dentists consolidate in response to increases in concentration among commercial dental insurers.

Suggested Citation

  • Kamyar Nasseh & John R. Bowblis & Marko Vujicic & Sean Shenghsiu Huang, 2020. "Consolidation in the dental industry: a closer look at dental payers and providers," International Journal of Health Economics and Management, Springer, vol. 20(2), pages 145-162, June.
    • Handle: RePEc:kap:ijhcfe:v:20:y:2020:i:2:d:10.1007_s10754-019-09274-x
    DOI: 10.1007/s10754-019-09274-x
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10754-019-09274-x
    File Function: Abstract
    Download Restriction: Access to full text is restricted to subscribers.
    File URL: https://libkey.io/10.1007/s10754-019-09274-x?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Kate Ho & Robin S. Lee, 2017. "Insurer Competition in Health Care Markets," Econometrica, Econometric Society, vol. 85, pages 379-417, March.
    2. Douglas Staiger & James H. Stock, 1997. "Instrumental Variables Regression with Weak Instruments," Econometrica, Econometric Society, vol. 65(3), pages 557-586, May.
    3. Trish, Erin E. & Herring, Bradley J., 2015. "How do health insurer market concentration and bargaining power with hospitals affect health insurance premiums?," Journal of Health Economics, Elsevier, vol. 42(C), pages 104-114.
    4. Dranove, David & J. Simon, Carol & White, William D., 1998. "Determinants of managed care penetration," Journal of Health Economics, Elsevier, vol. 17(6), pages 729-745, December.
    5. Laurie Bates & Rexford Santerre, 2008. "Do health insurers possess monopsony power in the hospital services industry?," International Journal of Health Economics and Management, Springer, vol. 8(1), pages 1-11, March.
    6. Abe Dunn & Adam Hale Shapiro, 2014. "Do Physicians Possess Market Power?," Journal of Law and Economics, University of Chicago Press, vol. 57(1), pages 159-193.
    7. Dafny Leemore & Dranove David & Limbrock Frank & Scott Morton Fiona, 2011. "Data Impediments to Empirical Work on Health Insurance Markets," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 11(2), pages 1-24, January.
    8. Peter Davis, 2006. "Measuring The Business Stealing, Cannibalization And Market Expansion Effects Of Entry In The U.S. Motion Picture Exhibition Market," Journal of Industrial Economics, Wiley Blackwell, vol. 54(3), pages 293-321, September.
    9. Steven T. Berry & Joel Waldfogel, 2001. "Do Mergers Increase Product Variety? Evidence from Radio Broadcasting," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 116(3), pages 1009-1025.
    10. Jeffrey M. Wooldridge, 2015. "Control Function Methods in Applied Econometrics," Journal of Human Resources, University of Wisconsin Press, vol. 50(2), pages 420-445.
    11. Gary Chamberlain, 1980. "Analysis of Covariance with Qualitative Data," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 47(1), pages 225-238.
    12. Brunt, Christopher S. & Bowblis, John R., 2014. "Health insurer market power and primary care consolidation," Economics Letters, Elsevier, vol. 125(1), pages 61-65.
    13. Papke, Leslie E. & Wooldridge, Jeffrey M., 2008. "Panel data methods for fractional response variables with an application to test pass rates," Journal of Econometrics, Elsevier, vol. 145(1-2), pages 121-133, July.
    14. Moriya, Asako S. & Vogt, William B. & Gaynor, Martin, 2010. "Hospital prices and market structure in the hospital and insurance industries," Health Economics, Policy and Law, Cambridge University Press, vol. 5(4), pages 459-479, October.
    15. Ian McCarthy & Sean Shenghsiu Huang, 2018. "Vertical Alignment Between Hospitals and Physicians as a Bargaining Response to Commercial Insurance Markets," Review of Industrial Organization, Springer;The Industrial Organization Society, vol. 53(1), pages 7-29, August.
    16. Laurence C. Baker & Martin L. Brown, 1999. "Managed Care, Consolidation Among Health Care Providers, and Health Care: Evidence from Mammography," RAND Journal of Economics, The RAND Corporation, vol. 30(2), pages 351-374, Summer.
    17. Unknown, 2014. "Media Coverage 2014," 2014: Ethics, Efficiency and Food Security: Feeding the 9 Billion, Well, 26-28 August 2014 225573, Crawford Fund.
    Full references (including those not matched with items on IDEAS)

    Citations

    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 13th July 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-07-13 11:00:06

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Korneta Piotr, 2020. "Stakeholders and Performance Management Systems of Small and Medium-Sized Outpatient Clinics," Foundations of Management, Sciendo, vol. 12(1), pages 211-222, January.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Brunt, Christopher S. & Bowblis, John R., 2014. "Health insurer market power and primary care consolidation," Economics Letters, Elsevier, vol. 125(1), pages 61-65.
    2. 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.
    3. Pelech, Daria, 2017. "Dropped out or pushed out? Insurance market exit and provider market power in Medicare Advantage," Journal of Health Economics, Elsevier, vol. 51(C), pages 98-112.
    4. Peter Dohmen & Martin Ineveld & Aniek Markus & Liana Hagen & Joris Klundert, 2023. "Does competition improve hospital performance: a DEA based evaluation from the Netherlands," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(6), pages 999-1017, August.
    5. Laurie Bates & Rexford Santerre, 2008. "Do health insurers possess monopsony power in the hospital services industry?," International Journal of Health Economics and Management, Springer, vol. 8(1), pages 1-11, March.
    6. Nyman, John A. & Koc, Cagatay & Dowd, Bryan E. & McCreedy, Ellen & Trenz, Helen Markelova, 2018. "Decomposition of moral hazard," Journal of Health Economics, Elsevier, vol. 57(C), pages 168-178.
    7. Wang, Jing & Lyu, Kaiyu & Lv, Xinye & Feil, Jan-Henning, 2021. "Rainfall Risk and Nonfarm Self-Employment in Rural China: Does Digital Finance Have a Role to Play?," 2021 Conference, August 17-31, 2021, Virtual 315326, International Association of Agricultural Economists.
    8. Naomi Hausman & Kurt Lavetti, 2021. "Physician Practice Organization and Negotiated Prices: Evidence from State Law Changes," American Economic Journal: Applied Economics, American Economic Association, vol. 13(2), pages 258-296, April.
    9. Acuna, Jorge A. & Zayas-Castro, Jose L. & Feijoo, Felipe, 2022. "A bilevel Nash-in-Nash model for hospital mergers: A key to affordable care," Socio-Economic Planning Sciences, Elsevier, vol. 83(C).
    10. Eric Barrette & Gautam Gowrisankaran & Robert Town, 2020. "Countervailing Market Power and Hospital Competition," NBER Working Papers 27005, National Bureau of Economic Research, Inc.
    11. Laurie J. Bates & Kankana Mukherjee & Rexford E. Santerre, 2010. "Medical Insurance Coverage and Health Production Efficiency," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 77(1), pages 211-229, March.
    12. Laurie J. Bates & James I. Hilliard & Rexford E. Santerre, 2012. "Do Health Insurers Possess Market Power?," Southern Economic Journal, John Wiley & Sons, vol. 78(4), pages 1289-1304, April.
    13. Ian McCarthy & Sean Shenghsiu Huang, 2018. "Vertical Alignment Between Hospitals and Physicians as a Bargaining Response to Commercial Insurance Markets," Review of Industrial Organization, Springer;The Industrial Organization Society, vol. 53(1), pages 7-29, August.
    14. Babigumira, Ronnie & Angelsen, Arild & Buis, Maarten & Bauch, Simone & Sunderland, Terry & Wunder, Sven, 2014. "Forest Clearing in Rural Livelihoods: Household-Level Global-Comparative Evidence," World Development, Elsevier, vol. 64(S1), pages 67-79.
    15. Costa-Font, Joan & Vilaplana-Prieto, Cristina, 2022. "Health shocks and housing downsizing: How persistent is ‘ageing in place’?," Journal of Economic Behavior & Organization, Elsevier, vol. 204(C), pages 490-508.
    16. Caroline Krafft, 2020. "Why is fertility on the rise in Egypt? The role of women’s employment opportunities," Journal of Population Economics, Springer;European Society for Population Economics, vol. 33(4), pages 1173-1218, October.
    17. Céline Nauges & Jon Strand, 2017. "Water Hauling and Girls’ School Attendance: Some New Evidence from Ghana," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 66(1), pages 65-88, January.
    18. Sandra Rodriguez A., 2015. "Poder de monopsonio en el mercado de aseguramiento en salud en Colombia," Revista de Economía del Caribe 14779, Universidad del Norte.
    19. Arnd Kölling & Claus Schnabel, 2022. "Owners, external managers and industrial relations in German establishments," British Journal of Industrial Relations, London School of Economics, vol. 60(2), pages 424-443, June.
    20. Ainembabazi John Herbert & Francis H. Kemeze, 2022. "Working Paper 366 - Remittances and employment in family-owned firms: Evidence from Nigeria and Uganda," Working Paper Series 2492, African Development Bank.

    More about this item

    Keywords

    Dental insurance; Market structure; Dental care; Consolidation;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • L40 - Industrial Organization - - Antitrust Issues and Policies - - - General
    • L44 - Industrial Organization - - Antitrust Issues and Policies - - - Antitrust Policy and Public Enterprise, Nonprofit Institutions, and Professional Organizations

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:kap:ijhcfe:v:20:y:2020:i:2:d:10.1007_s10754-019-09274-x. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.