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The anatomy of a hospital system merger: the patient did not respond well to treatment

Author

Listed:
  • Martin Gaynor
  • Adam Sacarny
  • Raffaella Sadun
  • Chad Syverson
  • Shruthi Venkatesh

Abstract

Despite the continuing US hospital merger wave, it remains unclear how mergers change, or fail to change, hospital behavior and performance. We open the "black box" of hospital practices through a mega-merger between two for-profit chains. Benchmarking the merger's effects against the acquirer's stated aims, we show they achieved some of their goals, harmonizing electronic medical records and sending managers to target hospitals. Post-acquisition managerial processes were similar across the merged chain. However, these interventions failed to drive detectable gains in performance. Our findings demonstrate the importance of organizations for merger research in health care and the economy more generally.

Suggested Citation

  • Martin Gaynor & Adam Sacarny & Raffaella Sadun & Chad Syverson & Shruthi Venkatesh, 2022. "The anatomy of a hospital system merger: the patient did not respond well to treatment," CEP Discussion Papers dp1845, Centre for Economic Performance, LSE.
    • Handle: RePEc:cep:cepdps:dp1845
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    References listed on IDEAS

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    1. Nicholas Bloom & John Van Reenen, 2007. "Measuring and Explaining Management Practices Across Firms and Countries," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(4), pages 1351-1408.
    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. Zack Cooper & Stuart V Craig & Martin Gaynor & John Van Reenen, 2019. "The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 134(1), pages 51-107.
    4. 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.
    5. Nicholas Bloom & Carol Propper & Stephan Seiler & John Van Reenen, 2015. "The Impact of Competition on Management Quality: Evidence from Public Hospitals," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 82(2), pages 457-489.
    6. Nicholas Bloom & Renata Lemos & Raffaella Sadun & John Van Reenen, 2020. "Healthy Business? Managerial Education and Management in Health Care," The Review of Economics and Statistics, MIT Press, vol. 102(3), pages 506-517, July.
    7. Amitabh Chandra & Amy Finkelstein & Adam Sacarny & Chad Syverson, 2016. "Health Care Exceptionalism? Performance and Allocation in the US Health Care Sector," American Economic Review, American Economic Association, vol. 106(8), pages 2110-2144, August.
    8. Nicholas Bloom & Christos Genakos & Raffaella Sadun & John Van Reenen, 2011. "Management Practices Across Firms and Countries," CEP Discussion Papers dp1109, Centre for Economic Performance, LSE.
    9. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    10. Joseph Doyle & John Graves & Jonathan Gruber, 2019. "Evaluating Measures of Hospital Quality: Evidence from Ambulance Referral Patterns," The Review of Economics and Statistics, MIT Press, vol. 101(5), pages 841-852, December.
    11. Katharina Janke & Carol Propper & Raffaella Sadun, 2019. "The Role of Top Managers in the Public Sector: Evidence from the English NHS," NBER Working Papers 25853, National Bureau of Economic Research, Inc.
    12. Propper, Carol & Janke, Katharina & Sadun, Raffaella, 2019. "The Impact of CEOs in the Public Sector: Evidence from the English NHS," CEPR Discussion Papers 13726, C.E.P.R. Discussion Papers.
    13. Christopher Garmon, 2017. "The accuracy of hospital merger screening methods," RAND Journal of Economics, RAND Corporation, vol. 48(4), pages 1068-1102, December.
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    More about this item

    JEL classification:

    • D22 - Microeconomics - - Production and Organizations - - - Firm Behavior: Empirical Analysis
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • M12 - Business Administration and Business Economics; Marketing; Accounting; Personnel Economics - - Business Administration - - - Personnel Management; Executives; Executive Compensation

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