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Rural Hospital Ownership: Medical Service Provision, Market Mix, and Spillover Effects


  • Jill R. Horwitz
  • Austin Nichols


Roughly one half of hospitals in the U.S. are in rural areas, yet researchers have largely studied the effects of hospital ownership in the urban context. We examine differences in the provision of profitable and unprofitable medical services in rural areas across nonprofit, for-profit, and government hospitals. We also consider the effect of hospital ownership mix within rural hospital markets. We find that rural nonprofit hospitals are more likely than for-profit hospitals to offer unprofitable services, many of which are underprovided services. Nonprofits respond less than for-profits to changes in service profitability. Nonprofits with more for-profit competitors offer more profitable services and fewer unprofitable services than those with fewer for-profit competitors.

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  • Jill R. Horwitz & Austin Nichols, 2011. "Rural Hospital Ownership: Medical Service Provision, Market Mix, and Spillover Effects," NBER Working Papers 16926, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:16926
    Note: HC HE

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    Cited by:

    1. Bowblis John R. & Brunt Christopher S. & Grabowski David C., 2016. "Competitive Spillovers and Regulatory Exploitation by Skilled Nursing Facilities," Forum for Health Economics & Policy, De Gruyter, vol. 19(1), pages 45-70, June.

    More about this item

    JEL classification:

    • H1 - Public Economics - - Structure and Scope of Government
    • I1 - Health, Education, and Welfare - - Health
    • L1 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance
    • L13 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Oligopoly and Other Imperfect Markets
    • L22 - Industrial Organization - - Firm Objectives, Organization, and Behavior - - - Firm Organization and Market Structure
    • L3 - Industrial Organization - - Nonprofit Organizations and Public Enterprise

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