infarction (reported by the state of California). Measures of competition are constructed for each hospital and payer type. The … of competition for HMO patients decrease risk-adjusted hospital mortality rates. Conversely, increases in competition for …. Increasing competition has little net effect on hospital quality for our sample …

form of insurance in the private sector. Also, a wave of hospital consolidation occurred. In 1990, the mean population …-weighted hospital Herfindahl-Hirschman Index (HHI) in a Health Services Area (HSA) was .19. By 2000, the HHI had risen to .26. This … paper explores whether the rise in managed care caused the increase in hospital concentration. We use an instrumental …