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Nash bargaining model of HMO premiums

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  • Roland Maude-Griffin
  • Roger Feldman
  • Douglas Wholey

Abstract

This paper estimates a model of commercial HMO premiums based on Nash's axiomatic approach to bargaining between HMOs and employers. The bargaining models incorporate variables that measure the 'power' of the parties to affect the division of potential gains from a contract. It is found that an increase in the number of competing HMOs increases the employer's bargaining power and leads to lower premiums, especially for for-profit HMOs. It is also found that employers' bargaining power over non-profit HMOs is positively related to the ratio of the HMO's administrative expenses/total expenses.

Suggested Citation

  • Roland Maude-Griffin & Roger Feldman & Douglas Wholey, 2004. "Nash bargaining model of HMO premiums," Applied Economics, Taylor & Francis Journals, vol. 36(12), pages 1329-1336.
  • Handle: RePEc:taf:applec:v:36:y:2004:i:12:p:1329-1336
    DOI: 10.1080/0003684042000238938
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    References listed on IDEAS

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    1. Wholey, Douglas & Feldman, Roger & Christianson, Jon B., 1995. "The effect of market structure on HMO premiums," Journal of Health Economics, Elsevier, vol. 14(1), pages 81-105, May.
    2. Brooks, John M. & Dor, Avi & Wong, Herbert S., 1997. "Hospital-insurer bargaining: An empirical investigation of appendectomy pricing," Journal of Health Economics, Elsevier, vol. 16(4), pages 417-434, August.
    3. Caroline Hoxby & M. Daniele Paserman, 1998. "Overidentification Tests with Grouped Data," NBER Technical Working Papers 0223, National Bureau of Economic Research, Inc.
    4. Davidson, Russell & MacKinnon, James G., 1993. "Estimation and Inference in Econometrics," OUP Catalogue, Oxford University Press, number 9780195060119.
    5. Wholey, Douglas & Feldman, Roger & Christianson, Jon B. & Engberg, John, 1996. "Scale and scope economies among health maintenance organizations," Journal of Health Economics, Elsevier, vol. 15(6), pages 657-684, December.
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    Cited by:

    1. Leo Turcotte & John Robst & Solomon Polachek, 2006. "Medical interventions among pregnant women in fee-for-service and managed care insurance: a propensity score analysis," Applied Economics, Taylor & Francis Journals, vol. 38(13), pages 1513-1525.
    2. Crespi, John M. & Xia, Tian & Jones, Rodney D., 2008. "Competition, Bargaining Power, and the Cattle Cycle," 2008 Annual Meeting, July 27-29, 2008, Orlando, Florida 6263, American Agricultural Economics Association (New Name 2008: Agricultural and Applied Economics Association).
    3. Douglas Wholey & John Engberg & Cindy Bryce, 2006. "A descriptive analysis of average productivity among health maintenance organizations, 1985 to 2001," Health Care Management Science, Springer, vol. 9(2), pages 189-206, May.

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