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Mergers and Marginal Costs: New Evidence on Hospital Buyer Power

Author

Listed:
  • Stuart Craig
  • Matthew Grennan
  • Ashley Swanson

Abstract

We estimate the effects of horizontal mergers on marginal cost efficiencies – an ubiquitous merger justification – using data containing supply purchase orders from a large sample of US hospitals 2009-2015. The data provide a level of detail that has been difficult to observe previously, and a variety of product categories that allows us to examine economic mechanisms underlying “buyer power.” We find that merger target hospitals save on average $176 thousand (or 1.5 percent) annually, driven by geographically local efficiencies in price negotiations for high-tech “physician preference items.” We find only mixed evidence on savings by acquirers.

Suggested Citation

  • Stuart Craig & Matthew Grennan & Ashley Swanson, 2018. "Mergers and Marginal Costs: New Evidence on Hospital Buyer Power," NBER Working Papers 24926, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:24926
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    Cited by:

    1. Sharat Ganapati & Rebecca McKibbin, 2019. "Non-Tariff Barriers and Bargaining in Generic Pharmaceuticals," Working Papers gueconwpa~18-18-23, Georgetown University, Department of Economics.
    2. Javier Donna & Andre Trindade & Pedro Pereira & Tiago Pires, 2018. "Measuring the Welfare of Intermediation in Vertical Markets," 2018 Meeting Papers 984, Society for Economic Dynamics.
    3. Jiajia Cong & Wen Zhou, 2024. "Sequential mergers under incomplete information," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 33(1), pages 131-154, January.
    4. Ivan Badinski & Amy Finkelstein & Matthew Gentzkow & Peter Hull, 2023. "Geographic Variation in Healthcare Utilization: The Role of Physicians," NBER Working Papers 31749, National Bureau of Economic Research, Inc.
    5. Lin, Haizhen & Wang, Yanhao, 2025. "The value of group purchasing: Evidence from the U.S. hospital industry," Journal of Public Economics, Elsevier, vol. 247(C).
    6. Gao, Janet & Kim, Yongseok & Sevilir, Merih, 2025. "Private equity in the hospital industry," Journal of Financial Economics, Elsevier, vol. 171(C).
    7. Bisceglia, Michele & Padilla, Jorge & Piccolo, Salvatore & Sääskilahti, Pekka, 2023. "On the bright side of market concentration in a mixed-oligopoly healthcare industry," Journal of Health Economics, Elsevier, vol. 90(C).
    8. Johannes S. Kunz & Carol Propper & Kevin E. Staub & Rainer Winkelmann, 2024. "Assessing the quality of public services: For‐profits, chains, and concentration in the hospital market," Health Economics, John Wiley & Sons, Ltd., vol. 33(9), pages 2162-2181, September.
    9. Luan, Mengna & Tao, Zhigang & Yuan, Hongjie, 2023. "Monopsony power and workers’ switching costs: Evidence from hospitals in China," Economics Letters, Elsevier, vol. 233(C).
    10. Donna, Javier D. & Pereira, Pedro & Pires, Tiago & Trindade, Andre, 2018. "Measuring the Welfare of Intermediaries in Vertical Markets," MPRA Paper 90465, University Library of Munich, Germany.
    11. Ralph B. Siebert, 2022. "What Determines Heterogeneous Merger Effects on Competitive Outcomes?," Journal of Industrial Economics, Wiley Blackwell, vol. 70(1), pages 217-256, March.
    12. Allende, Claudia & Atal, Juan Pablo & Carril, Rodrigo & Cuesta, José Ignacio & González-Lira, Andrés, 2024. "Drivers of public procurement prices: Evidence from pharmaceutical markets," International Journal of Industrial Organization, Elsevier, vol. 96(C).
    13. Stephen McCarthy & Damien Sheehan‐Connor, 2022. "The effect of hospital‐physician integration on hospital costs," Health Economics, John Wiley & Sons, Ltd., vol. 31(11), pages 2333-2368, November.
    14. Lin, Haizhen & McCarthy, Ian M. & Richards, Michael, 2021. "Hospital Pricing Following Integration with Physician Practices," Journal of Health Economics, Elsevier, vol. 77(C).

    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • L40 - Industrial Organization - - Antitrust Issues and Policies - - - General

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