Physician Competition in the Era of Accountable Care Organizations
Physician Competition in the Era of Accountable Care Organizations
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DOI：
10.1111/1475-6773.12690
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发表时间：
2018-04-01
影响因子：
3.4
通讯作者：
Resnick, Matthew J.
中科院分区：
文献类型：
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作者：
Richards, Michael R.;Smith, Catherine T.;Resnick, Matthew J.
ObjectiveObjectiveComputerConcentration Levels for all U.S. markets using detailed data on integration and accountable care organizations（ACO）participation.Data Source2015 SK&A office-based medicine survey linked to all commercial and public payer ACOs.Study DesignWe construct three separate Herfindahl-Hirschman Index（HHI）measures and plot their distribution.然后，我们调查如何将更详细的组织特征纳入HHI measure.Principal FindingsHorizontal和Vertical Integration的浓度变化的普遍水平强烈影响医生浓度的措施，但是，ACO整体影响有限。ACO往往存在于竞争激烈的市场，只有在少数这些市场做ACO大幅增加医生concentration.ConclusionsMonitoring ACO对医生的竞争的影响将可能不得不进行个案的基础上。
ObjectiveTo calculate physician concentration levels for all U.S. markets using detailed data on integration and accountable care organization (ACO) participation.Data Source2015 SK&A office-based physician survey linked to all commercial and public payer ACOs.Study DesignWe construct three separate Herfindahl-Hirschman Index (HHI) measures and plot their distributions. We then investigate how prevailing levels of concentration change when incorporating more detailed organizational features into the HHI measure.Principal FindingsHorizontal and vertical integration strongly influences measures of physician concentration; however, ACOs have limited impact overall. ACOs are often present in competitive markets, and only in a minority of these markets do ACOs substantively increase physician concentration.ConclusionsMonitoring ACO effects on physician competition will likely have to proceed on a case-by-case basis.