The impact of provider consolidation on physician prices
The impact of provider consolidation on physician prices
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DOI：
10.1002/hec.3502
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发表时间：
2017-12-01
期刊：
影响因子：
2.1
通讯作者：
Dowd, Bryan
中科院分区：
文献类型：
--
作者：
Carlin, Caroline S.;Feldman, Roger;Dowd, Bryan
当一个诊所系统被一个综合交付系统（IDS）收购时，所有权的变化包括与医院的垂直整合，以及与IDS以前拥有的或遗留诊所的水平整合，导致医生服务的市场集中度增加。虽然有一个强大的文献医院市场集中度的影响，医生市场集中度的文献是稀疏的。本研究的目的是确定医生价格的影响时，两个IDS收购了三个多专科诊所系统在明尼阿波利斯圣保罗，明尼苏达州在2007年底，使用商业索赔数据从一个大型健康计划（2006-2011年）。使用差异中的差异模型和非收购诊所作为对照，我们发现收购后四年（2011年），收购诊所系统的平均医生价格指数比没有收购的预期高出32-47%。2011年，IDS传统诊所的平均医生价格比预期高出14-20%。收购后，普通门诊和住院手术的特定手术价格也有所上涨。
When a clinic system is acquired by an integrated delivery system (IDS), the ownership change includes both vertical integration with the hospital(s), and horizontal integration with the IDS's previously owned or legacy clinics, causing increased market concentration in physician services. Although there is a robust literature on the impact of hospital market concentration, the literature on physician market concentration is sparse. The objective of this study is to determine the impact on physician prices when two IDSs acquired three multispecialty clinic systems in Minneapolis-St Paul, Minnesota at the end of 2007, using commercial claims data from a large health plan (2006-2011). Using a difference-in-differences model and nonacquired clinics as controls, we found that fouryears after the acquisitions (2011), average physician price indices in the acquired clinic systems were 32-47% higher than expected in absence of the acquisitions. Average physician prices in the IDS legacy clinics were 14-20% higher in 2011 than expected. Procedure-specific prices for common office visit and inpatient procedures also increased following the acquisitions.