A common reform used to increase consumer choice and competition in public services has been to allow private providers to compete with public incumbents. However, there remains a concern that not all consumers are able to benefit equally from wider choice. We consider the case of publicly...

In this paper we investigate the existence of a two-tier medical system in the German acute care hospital sector using data from a survey of 483 German hospitals. The focus of our analysis lies on the impact of hospital concentration on the probability of discrimination of patients with...

In this paper we investigate the existence of a two-tier medical system in the German acute care hospital sector using data from a survey of 483 German hospitals. The focus of our analysis lies on the impact of hospital concentration on the probability of discrimination of patients with...

In 2016 the Federal Trade Commission (“FTC”) lost motions for preliminary injunction in two separate hospital mergers. In both cases the district courts rejected the FTC's geographic market definition based on flawed interpretations of the “hypothetical monopolist” test. Fortunately, the...

In the health insurance marketplaces established by the Affordable Care Act (ACA), eachstate is divided into a set number of geographic “rating areas.” The ACA mandates that aninsurer price its health insurance plan uniformly in all counties within the same rating area,conditional on...

A central question in the debate over privatized Medicare is whether increased government payments to private Medicare Advantage (MA) plans generate lower premiums for consumers or higher profits for producers. Using difference-in-differences variation brought about by a sharp legislative...

In 2005, competition was introduced in part of the hospital market in the Netherlands. Using a unique dataset of transactions and list prices between hospitals and insurers in the years 2005 and 2006, we estimate the influence of buyer and seller concentration on the negotiated prices. First, we...

Efforts to understand the relationship between market structure and the quality of health services are complicated by the non-random character of patients' choices of where to receive care. To address this problem, I construct an empirical model of health outcomes for dialysis patients that...

Despite their widespread usage, little is known about the predictive accuracy of different discrete choice demand models. To evaluate their performance, we use a series of natural disasters that unexpectedly removed hospitals from consumers' choice sets. We compare the model predictions of...

We study how inertia interacts with market power and adverse selection in managed competition health insurance markets. We use consumer-level data to estimate a model of the California ACA exchange, in which four firms dominate the market and risk adjustment is in place to manage selection. We...