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Author: James R Godwin Publisher: ISBN: Category : Languages : en Pages : 192
Book Description
The United States spends a larger percentage of GDP on healthcare than any other OECD nation, and yet it performs poorly on measures of access, process quality and outcomes relative to other wealthy nations. One hypothesis that may explain the relatively poor performance of the United States' healthcare system per dollar spent is that markets for hospitals, physician services, and insurance are highly consolidated and lack competition. This dissertation contributes to the body of literature seeking to measure healthcare market structure and assess the relationship between this market structure and unit prices, overall spending, and healthcare quality. The first paper in this dissertation, "The Association between Hospital-Physician Vertical Integration and Outpatient Physician Prices Paid by Commercial Insurers: New Evidence," demonstrates market-level associations between vertical integration among hospitals and physicians and higher prices for outpatient care. The second essay, "How Hospital-Owned Physician Organizations are Associated with Healthcare Prices, Expenditures, and Quality," analyzes vertical integration and prices, quality, and total patient spending, building on the findings of the first essay using physician and hospital level claims data. This study finds that vertical integration is associated with higher levels of annual spending for patients attributed to vertically integrated providers, but interpretation of association between vertical integration and outpatient prices is confounded by pre-intervention trends. Analysis of CMS hospital outcome measures does not show associations between vertical integration at a hospital level and quality. Finally, the third essay, "Automated Delineation of Hospital Market Boundaries in California," explores geographic market definition in healthcare, an important topic in research and antitrust action, while assessing the application of community detection methods in this field. This study finds that community detection methods group hospitals with higher accuracy than other geographic markets as measured by patient flows and may offer promise for merger screening, research on market concentration, and research on geographic variation in healthcare. The final chapter reviews overarching limitations of the dissertation, outlines directions for future research, and comments on potential policy approaches to promote competition and address the symptoms that may result from highly consolidated healthcare markets
Author: James R Godwin Publisher: ISBN: Category : Languages : en Pages : 192
Book Description
The United States spends a larger percentage of GDP on healthcare than any other OECD nation, and yet it performs poorly on measures of access, process quality and outcomes relative to other wealthy nations. One hypothesis that may explain the relatively poor performance of the United States' healthcare system per dollar spent is that markets for hospitals, physician services, and insurance are highly consolidated and lack competition. This dissertation contributes to the body of literature seeking to measure healthcare market structure and assess the relationship between this market structure and unit prices, overall spending, and healthcare quality. The first paper in this dissertation, "The Association between Hospital-Physician Vertical Integration and Outpatient Physician Prices Paid by Commercial Insurers: New Evidence," demonstrates market-level associations between vertical integration among hospitals and physicians and higher prices for outpatient care. The second essay, "How Hospital-Owned Physician Organizations are Associated with Healthcare Prices, Expenditures, and Quality," analyzes vertical integration and prices, quality, and total patient spending, building on the findings of the first essay using physician and hospital level claims data. This study finds that vertical integration is associated with higher levels of annual spending for patients attributed to vertically integrated providers, but interpretation of association between vertical integration and outpatient prices is confounded by pre-intervention trends. Analysis of CMS hospital outcome measures does not show associations between vertical integration at a hospital level and quality. Finally, the third essay, "Automated Delineation of Hospital Market Boundaries in California," explores geographic market definition in healthcare, an important topic in research and antitrust action, while assessing the application of community detection methods in this field. This study finds that community detection methods group hospitals with higher accuracy than other geographic markets as measured by patient flows and may offer promise for merger screening, research on market concentration, and research on geographic variation in healthcare. The final chapter reviews overarching limitations of the dissertation, outlines directions for future research, and comments on potential policy approaches to promote competition and address the symptoms that may result from highly consolidated healthcare markets
Author: Einer Elhauge Publisher: Oxford University Press, USA ISBN: 019539013X Category : Health & Fitness Languages : en Pages : 397
Book Description
Why is the American health care system so fragmented in the care it gives patients? This title approaches this question and more with a highly interdisciplinary approach. The articles included in the work address legal and regulatory issues, including laws that mandate separate payments for each provider.
Author: Leiyu Shi Publisher: Jones & Bartlett Learning ISBN: 0763763802 Category : Business & Economics Languages : en Pages : 386
Book Description
Covering the basic structures and operations of the U.S. health system, Essentials of the U.S. Health Care System is a clear and concise distillation of the important topics covered in Delivering Health Care in America by the same authors. Ideal for courses in health policy, allied health, health administration and more, this comprehensive revision clarifies the complexities of health care organization and finance and presents a solid overview of how the various components fit together. The Second Edition has been thoroughly updated with all new data, charts, and tables throughout.
Author: Frank W. Musgrave Publisher: Routledge ISBN: 1317457242 Category : Business & Economics Languages : en Pages : 191
Book Description
Designed as a primary text for courses in health care economics and policy analysis, this comprehensive work places the issues and economic analysis of the health care industry in the context of market forces driving the industry, including negotiated markets, managed care, and the growing influence of oligopolies. Written in accessible prose, without the aid of technical jargon and mathematical formulations, the content is rich with applicable, understandable economic concepts and analysis, and examples of market failure and government involvement. Some of the major policy issues covered are drug pricing, Medicare and Medicaid reform, the medically uninsured, for-profit hospital monopoly price power, managed care competitive pricing, and new negotiated markets. The relevant economic concepts employed in the text include price elasticity of demand/supply, market structure from competitive to oligopolistic markets, monopoly pricing power, measures of health care inflation and the biases of the CPI, demand and supply factors, inverse relationship of present health care expenditures as a percentage of GDP, measures/concepts of efficiency, and the role of government in a market era.
Author: Łukasz Jasiński Publisher: Taylor & Francis ISBN: 1000902986 Category : Business & Economics Languages : en Pages : 169
Book Description
The Patient Protection and Affordable Care Act (commonly referred to as ObamaCare or PPACA), which was signed into US law in 2010, generated a lot of noise from both supporters and detractors. This book argues that the changes introduced by ObamaCare were, in the long history of government intervention in the US health system, generally not as new or novel as claimed. The scope of the changes introduced by ObamaCare is very wide and covers, among others: the health insurance industry, pharmaceuticals, employers, employees, or the uninsured. The structure of the book shows the individual causes, key assumptions, and impacts of the reform on individual elements or areas of the US health system. One of the most important aspects of the work is analysis of the phenomenon of the so-called ‘death spiral’. The changes introduced by ObamaCare reform make it possible to investigate the causes of this phenomenon on a country-wide scale and enable a broader analysis of its effects. The book will be of great interest to readers in the economics, management and policy of health and health care.
Author: Xing Wu Publisher: ISBN: Category : Languages : en Pages : 0
Book Description
Over the last decades, health economics has turned into one of the most active research fields within economics. The structure of health care markets varies enormously across countries, largely influenced by competition among suppliers, the regulation of markets and patient preferences. This dissertation presents an analysis of health care markets especially focusing on price competition and quality competition. Under price competition, a pair of asymmetric pure strategy price equilibria exists in a model with income constraints for the specific case that two physicians locate at the maximum distance from each other and patients pay the same marginal transportation cost. Under quality competition, I investigate the interplay of market transparency and semi-altruism - a specific and interesting aspect unique to markets for health care. Market transparency and semi-altruism show ambiguous effects on welfare. The more altruistic physicians provides weakly higher quality than the less altruistic one. Moreover, I explore individual and social incentives for hospital mergers and their interaction with transparency and find that higher transparency does not always lead to higher quality and higher social welfare. The results indicate that quality is lower after merger. A hospital merger leads to a higher social welfare if the efficiency gains from the merger are sufficiently large. ; eng
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309036437 Category : Medical Languages : en Pages : 580
Book Description
"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.
Author: Donald A. Barr Publisher: JHU Press ISBN: 1421420716 Category : Business & Economics Languages : en Pages : 451
Book Description
The fourth edition of the essential guide to the contemporary US health care system. Winner of the CHOICE Outstanding Academic Title of the Choice ACRL Health care reform has been a dominant theme in public discourse for decades now. The passage of the Affordable Care Act was a major milestone, but rather than quell the rhetoric, it has sparked even more heated debate. In the latest edition of Introduction to US Health Policy, Donald A. Barr reviews the current structure of the American health care system, describing the historical and political contexts in which it developed and the core policy issues that continue to confront us today. Barr’s comprehensive analysis explores the various organizations and institutions that make the US health care system work—or fail to work. He describes in detail the paradox of US health care—simultaneously the best in the world and one of the worst among developed countries—while introducing readers to broad cultural issues surrounding health care policy, such as access, affordability, and quality. Barr also discusses specific elements of US health care with depth and nuance, including insurance, especially Medicare and Medicaid. He scrutinizes the shift to for-profit managed care while analyzing the pharmaceutical industry, issues surrounding long-term care, the plight of the uninsured, the prevalence of medical errors, and the troublesome issue of nursing shortages. The thoroughly updated edition of this widely adopted text focuses on the Affordable Care Act. It explains the steps taken to carry out the Act, the changes to the Act based on recent Supreme Court decisions, the success of the Act in achieving the combined goals of improved access to care and constraining the costs of care, and the continuing political controversy regarding its future. Drawing on an extensive range of resources, including government reports, scholarly publications, and analyses from a range of private organizations, Introduction to US Health Policy provides scholars, policymakers, and health care providers with a comprehensive platform of ideas that is key to understanding and influencing the changes in the US health care system.
Author: James R Godwin
Author: James R Godwin
Author: Ayse S. Diebel
Author: D. Andrew Austin
Author: Einer Elhauge
Author: Leiyu Shi
Author: Frank W. Musgrave
Author: Łukasz Jasiński
Author: Xing Wu
Author: Institute of Medicine
Author: Donald A. Barr