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Can Empirical Demand Models Assist in CON Comparative Reviews? A Case Study in Florida

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  • Gary M. Fournier

Abstract

Certificate‐of‐Need (CON) programs for new hospital construction are intended to foster the best selection among competing hospital applications, given demands for hospital care in the community. Yet, the merits of CON depend in part on the quality of the comparative review process. This article examines a case study in Florida to illustrate the utility of empirical evaluations using patient choice models. I estimate such models to show how patients would respond to a change in hospital choices. By simulating the welfare effects of the proposed hospitals, I can further predict how prices of hospital care differ by applicant. Results suggest that empirical analysis using data on patient choice of hospitals may better inform the review process. At the same time, however, it may not give a unique ranking without additional analysis of the fixed costs of proposed services in the context of existing marketwide capacity.

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  • Gary M. Fournier, 2014. "Can Empirical Demand Models Assist in CON Comparative Reviews? A Case Study in Florida," Southern Economic Journal, John Wiley & Sons, vol. 81(1), pages 68-90, July.
    • Handle: RePEc:wly:soecon:v:81:y:2014:i:1:p:68-90
    DOI: 10.4284/0038-4038-2011.011
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    1. Ken Binmore & Ariel Rubinstein & Asher Wolinsky, 1986. "The Nash Bargaining Solution in Economic Modelling," RAND Journal of Economics, The RAND Corporation, vol. 17(2), pages 176-188, Summer.
    2. Gautam Gowrisankaran & Aviv Nevo & Robert Town, 2015. "Mergers When Prices Are Negotiated: Evidence from the Hospital Industry," American Economic Review, American Economic Association, vol. 105(1), pages 172-203, January.
    3. Sara Fisher Ellison & Christopher M. Snyder, 2010. "Countervailing Power In Wholesale Pharmaceuticals," Journal of Industrial Economics, Wiley Blackwell, vol. 58(1), pages 32-53, March.
    4. Jean Marie Abraham & Martin Gaynor & William B. Vogt, 2007. "Entry And Competition In Local Hospital Markets," Journal of Industrial Economics, Wiley Blackwell, vol. 55(2), pages 265-288, June.
    5. Moriya, Asako S. & Vogt, William B. & Gaynor, Martin, 2010. "Hospital prices and market structure in the hospital and insurance industries," Health Economics, Policy and Law, Cambridge University Press, vol. 5(4), pages 459-479, October.
    6. Lynk, William J., 1995. "The creation of economic efficiencies in hospital mergers," Journal of Health Economics, Elsevier, vol. 14(5), pages 507-530, December.
    7. Keeler, Emmett B. & Melnick, Glenn & Zwanziger, Jack, 1999. "The changing effects of competition on non-profit and for-profit hospital pricing behavior," Journal of Health Economics, Elsevier, vol. 18(1), pages 69-86, January.
    8. Esther Gal‐Or, 1999. "Mergers and Exclusionary Practices in Health Care Markets," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 8(3), pages 315-350, September.
    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. Cory S. Capps & David Dranove & Shane Greenstein & Mark Satterthwaite, 2001. "The Silent Majority Fallacy of the Elzinga-Hogarty Criteria: A Critique and New Approach to Analyzing Hospital Mergers," NBER Working Papers 8216, National Bureau of Economic Research, Inc.
    11. Melnick, Glenn A. & Zwanziger, Jack & Bamezai, Anil & Pattison, Robert, 1992. "The effects of market structure and bargaining position on hospital prices," Journal of Health Economics, Elsevier, vol. 11(3), pages 217-233, October.
    12. Capps, Cory & Dranove, David & Satterthwaite, Mark, 2003. "Competition and Market Power in Option Demand Markets," RAND Journal of Economics, The RAND Corporation, vol. 34(4), pages 737-763, Winter.
    13. Dranove, David & Ludwick, Richard, 1999. "Competition and pricing by nonprofit hospitals: a reassessment of Lynk's analysis," Journal of Health Economics, Elsevier, vol. 18(1), pages 87-98, January.
    14. Town, Robert & Vistnes, Gregory, 2001. "Hospital competition in HMO networks," Journal of Health Economics, Elsevier, vol. 20(5), pages 733-753, September.
    15. Sloan, Frank A, 1982. "Government and the Regulation of Hospital Care," American Economic Review, American Economic Association, vol. 72(2), pages 196-201, May.
    16. Staten, Michael & Umbeck, John & Dunkelberg, William, 1988. "Market share/market power revisited : A new test for an old theory," Journal of Health Economics, Elsevier, vol. 7(1), pages 73-83, March.
    17. Dranove, David & Shanley, Mark & White, William D, 1993. "Price and Concentration in Hospital Markets: The Switch from Patient-Driven to Payer-Driven Competition," Journal of Law and Economics, University of Chicago Press, vol. 36(1), pages 179-204, April.
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