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The role of hospital networks in individual mortality

Author

Listed:
  • Giancarlo Buitrago

    (Universidad Nacional de Colombia)

  • Paul Rodríguez-Lesmes

    (Institute for Fiscal Studies)

  • Natalia Serna

    (Stanford University)

  • Marcos Vera-Hernandez

    (Institute for Fiscal Studies)

Abstract

Narrow hospital networks have proliferated in health systems with managed care competition. In this paper, we investigate the causal effect of hospital network breadth on patient mortality. We leverage insurer terminations and subsequent hospital terminations for vertically integrated hospitals to identify this effect. We use data from the Colombian healthcare system where the largest health insurer and its hospitals were terminated by the end of 2015. Findings show that broad-network insurers reduce patient mortality because they include high-quality hospitals and can treat more health conditions. Our results suggest that in a setting without price competition, access to health care through a few insurers with broad networks is better for patient health than access to health care through many insurers with narrow networks.
(This abstract was borrowed from another version of this item.)

Suggested Citation

  • Giancarlo Buitrago & Paul Rodríguez-Lesmes & Natalia Serna & Marcos Vera-Hernandez, 2024. "The role of hospital networks in individual mortality," IFS Working Papers W24/21, Institute for Fiscal Studies.
  • Handle: RePEc:ifs:ifsewp:24/21
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    References listed on IDEAS

    as
    1. Leemore Dafny & Igal Hendel & Nathan Wilson, 2015. "Narrow Networks on the Health Insurance Exchanges: What Do They Look Like and How Do They Affect Pricing? A Case Study of Texas," American Economic Review, American Economic Association, vol. 105(5), pages 110-114, May.
    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. Mark Shepard, 2022. "Hospital Network Competition and Adverse Selection: Evidence from the Massachusetts Health Insurance Exchange," American Economic Review, American Economic Association, vol. 112(2), pages 578-615, February.
    4. Farrell, Joseph & Klemperer, Paul, 2007. "Coordination and Lock-In: Competition with Switching Costs and Network Effects," Handbook of Industrial Organization, in: Mark Armstrong & Robert Porter (ed.), Handbook of Industrial Organization, edition 1, volume 3, chapter 31, pages 1967-2072, Elsevier.
    5. Jason Abaluck & Mauricio Caceres Bravo & Peter Hull: & Amanda Starc, 2021. "Mortality Effects and Choice Across Private Health Insurance Plans," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 136(3), pages 1557-1610.
    6. David Card & Carlos Dobkin & Nicole Maestas, 2008. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization: Evidence from Medicare," American Economic Review, American Economic Association, vol. 98(5), pages 2242-2258, December.
    7. Keeler, Emmett B & Newhouse, Joseph P & Phelps, C E, 1977. "Deductibles and the Demand for Medical Care Services: The Theory of a Consumer Facing a Variable Price Schedule under Uncertainty," Econometrica, Econometric Society, vol. 45(3), pages 641-655, April.
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    Full references (including those not matched with items on IDEAS)

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    More about this item

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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