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Estimation and Identification of Merger Effects: An Application to Hospital Mergers

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  • Leemore S. Dafny

Abstract

Advances in structural demand estimation have substantially improved economists' ability to forecast the impact of mergers. However, these models rely on extensive assumptions about consumer choice and firm objectives, and ultimately observational methods are needed to test their validity. Observational studies, in turn, suffer from selection problems arising from the fact that merging entities differ from non-merging entities in unobserved ways. To obtain an accurate estimate of the effect of consummated mergers, I propose a combination of rival analysis and instrumental variables. By focusing on the effect of a merger on the behavior of rival firms, and instrumenting for these mergers, unbiased estimates of the effect of a merger on market outcomes can be obtained. Using this methodology, I evaluate the impact of independent hospital mergers between 1989 and 1996 on rivals' prices. I find sharp increases in rivals' prices following a merger, with the greatest effect on the closest rivals. The results for this industry are more consistent with predictions from structural models than with prior observational estimates.

Suggested Citation

  • Leemore S. Dafny, 2005. "Estimation and Identification of Merger Effects: An Application to Hospital Mergers," NBER Working Papers 11673, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:11673
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    Cited by:

    1. Akosa Antwi Yaa & Gaynor Martin S & Vogt William B, 2009. "A Bargain at Twice the Price? California Hospital Prices in the New Millennium," Forum for Health Economics & Policy, De Gruyter, vol. 12(1), pages 1-23, July.
    2. Jeffrey Clemens & Joshua D. Gottlieb, 2017. "In the Shadow of a Giant: Medicare’s Influence on Private Physician Payments," Journal of Political Economy, University of Chicago Press, vol. 125(1), pages 1-39.
    3. Sven‐Olof Fridolfsson & Johan Stennek, 2010. "Industry Concentration and Welfare: On the Use of Stock Market Evidence from Horizontal Mergers," Economica, London School of Economics and Political Science, vol. 77(308), pages 734-750, October.
    4. Robert Town & Douglas Wholey & Roger Feldman & Lawton R. Burns, 2006. "The Welfare Consequences of Hospital Mergers," NBER Working Papers 12244, National Bureau of Economic Research, Inc.
    5. Dranove, David & Lindrooth, Richard & White, William D. & Zwanziger, Jack, 2008. "Is the impact of managed care on hospital prices decreasing?," Journal of Health Economics, Elsevier, vol. 27(2), pages 362-376, March.
    6. Leemore Dafny & Mark Duggan & Subramaniam Ramanarayanan, 2012. "Paying a Premium on Your Premium? Consolidation in the US Health Insurance Industry," American Economic Review, American Economic Association, vol. 102(2), pages 1161-1185, April.
    7. Jeffrey T. Prince & Daniel H. Simon, 2017. "The Impact of Mergers on Quality Provision: Evidence from the Airline Industry," Journal of Industrial Economics, Wiley Blackwell, vol. 65(2), pages 336-362, June.
    8. Tom Chang & Mireille Jacobson, 2010. "Natural Disaster Management: Earthquake Risk and Hospitals' Provision of Essential Services in California," NBER Chapters, in: Regulation vs. Litigation: Perspectives from Economics and Law, pages 301-320, National Bureau of Economic Research, Inc.
    9. Melnick, Glenn & Keeler, Emmett, 2007. "The effects of multi-hospital systems on hospital prices," Journal of Health Economics, Elsevier, vol. 26(2), pages 400-413, March.
    10. Ed Westerhout & Kees Folmer, 2013. "Why it may hurt to be insured: the effects of capping coinsurance payments," CPB Discussion Paper 239.rdf, CPB Netherlands Bureau for Economic Policy Analysis.

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    More about this item

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • D4 - Microeconomics - - Market Structure, Pricing, and Design
    • L0 - Industrial Organization - - General

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