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The price effects of cross‐market mergers: theory and evidence from the hospital industry

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  • Leemore Dafny
  • Kate Ho
  • Robin S. Lee

Abstract

We consider the effect of mergers between firms whose products are not viewed as direct substitutes for the same good or service, but are bundled by a common intermediary. Focusing on hospital mergers across distinct geographic markets, we show that such combinations can reduce competition among merging hospitals for inclusion in insurers' networks, leading to higher prices (or lower‐quality care). Using data on hospital mergers from 1996–2012, we find support that this mechanism operates within state boundaries: cross‐market, within‐state hospital mergers yield price increases of 7%–9 % for acquiring hospitals, whereas out‐of‐state acquisitions do not yield significant increases.

Suggested Citation

  • Leemore Dafny & Kate Ho & Robin S. Lee, 2019. "The price effects of cross‐market mergers: theory and evidence from the hospital industry," RAND Journal of Economics, RAND Corporation, vol. 50(2), pages 286-325, June.
    • Handle: RePEc:bla:randje:v:50:y:2019:i:2:p:286-325
    DOI: 10.1111/1756-2171.12270
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    Cited by:

    1. Richards, Michael R. & Seward, Jonathan A. & Whaley, Christopher M., 2022. "Treatment consolidation after vertical integration: Evidence from outpatient procedure markets," Journal of Health Economics, Elsevier, vol. 81(C).
    2. Jonathan I. Dingel & Joshua D. Gottlieb & Maya Lozinski & Pauline Mourot, 2023. "Market Size and Trade in Medical Services," NBER Working Papers 31030, National Bureau of Economic Research, Inc.
    3. 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.
    4. Mônica Viegas Andrade & Carolina Marinho & Letícia Nunes & Flavia Colares, 2024. "Price setting in the Brazilian private health insurance sector," International Journal of Health Economics and Management, Springer, vol. 24(1), pages 57-80, March.
    5. Michael Vita & Keith Brand & Miriam Larson-Koester & Nathan Petek & Charles Taragin & William Violette & Daniel H. Wood, 2022. "Economics at the FTC: Estimating Harm from Deception and Analyzing Mergers," Review of Industrial Organization, Springer;The Industrial Organization Society, vol. 61(4), pages 405-438, December.
    6. Owsley, Kelsey M. & Lindrooth, Richard C., 2022. "Understanding the relationship between nonprofit hospital community benefit spending and system membership: An analysis of independent hospital acquisitions," Journal of Health Economics, Elsevier, vol. 86(C).
    7. Milstein, Ricarda & Schreyögg, Jonas, 2024. "The end of an era? Activity-based funding based on diagnosis-related groups: A review of payment reforms in the inpatient sector in 10 high-income countries," Health Policy, Elsevier, vol. 141(C).
    8. Haizhen Lin & Ian M. McCarthy, 2023. "Multimarket Contact in Health Insurance: Evidence from Medicare Advantage," Journal of Industrial Economics, Wiley Blackwell, vol. 71(1), pages 212-255, March.
    9. Chiara Brouns & Rudy Douven & Ron Kemp, 2021. "Prices and market power in mental health care: Evidence from a major policy change in the Netherlands," Health Economics, John Wiley & Sons, Ltd., vol. 30(4), pages 803-819, April.
    10. Zhou, Mei & Zhao, Shaoyang & Fu, Mingwei, 2021. "Supply-induced demand for medical services under price regulation: Evidence from hospital expansion in China," China Economic Review, Elsevier, vol. 68(C).
    11. Chiara Brouns & Rudy Douven & Ron Kemp, 2021. "Prices and market power in mental health care: Evidence from a major policy change in the Netherlands," Health Economics, John Wiley & Sons, Ltd., vol. 30(4), pages 803-819, April.
    12. Chorniy, Anna & Miller, Daniel & Tang, Tilan, 2020. "Mergers in Medicare Part D: Assessing market power, cost efficiencies, and bargaining power," International Journal of Industrial Organization, Elsevier, vol. 68(C).
    13. Stuart V. Craig & Matthew Grennan & Ashley Swanson, 2021. "Mergers and marginal costs: New evidence on hospital buyer power," RAND Journal of Economics, RAND Corporation, vol. 52(1), pages 151-178, March.
    14. Lin, Haizhen & McCarthy, Ian M. & Richards, Michael, 2021. "Hospital Pricing Following Integration with Physician Practices," Journal of Health Economics, Elsevier, vol. 77(C).
    15. Janssen, Aljoscha & Zhang, Xuan, 2020. "Retail Pharmacies and Drug Diversion during the Opioid Epidemic," Working Paper Series 1373, Research Institute of Industrial Economics.

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