We investigate the impact of hospital system membership on negotiations between hospitals and managed care organizations (MCOs). Previous research finds that system hospitals secure higher reimbursements by exploiting local market concentration. By leveraging system membership in the bargaining game, however, system hospitals may also extract a higher percentage of their value to an MCO. Our findings reveal that more of the observed price gap between system and nonsystem hospitals can be attributed to bargaining power differences than to differences linked to relative concentration. These results highlight the importance of explicitly modeling the bargaining process when evaluating negotiated-price markets more generally. (JEL C78, I11, I13, L14)

Analyses of hospital mergers typically focus on acquisitions that alter local market concentration. However, as prices are negotiated between hospital systems and insurers, this focus may overlook the impact of cross‐market interdependence in the bargaining outcome. Using data on out‐of‐market acquisitions occurring across the United States from 2000–2010, we investigate the impact of cross‐market dependencies on negotiated prices. We find that prices at hospitals acquired by out‐of‐market systems increase by about 17% more than unacquired, stand‐alone hospitals and confirm that out‐of‐market mergers result in a relaxation of competition, the prices of nearby competitors to acquired hospitals increase by around 8%.

. (2015) 'Revealed reputations in the nitely-repeated prisoners' dilemma.', Economic theory., 58 (3). pp. 441-484. Further information on publisher's website:http://dx.doi.org/10.1007/s00199-015-0863-1Publisher's copyright statement:The nal publication is available at Springer via http://dx.doi.org/10.1007/s00199-015-0863-1. Additional information:Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-pro t purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. Abstract In a sequential-move, finitely-repeated prisoners' dilemma game (FRPD), cooperation can be sustained if the first-mover believes her opponent might be a behavioral type who plays a tit-for-tat strategy in every period. We test this theory by revealing second-mover histories from an earlier FRPD experiment to their current opponent. Despite eliminating the possibility of reputation building, aggregate cooperation actually increases when histories are revealed. Cooperative histories lead to increased trust, but negative histories do not cause decreased trust. We develop a behavioral model to explain these findings.

I analyze the impact of physician competition for patients on treatment selection and an insurer's ability to induce its preferences through a supply-side payment mechanism. Informed patients choose the physician whose treatment practice best fits their preferences, aligning physician incentives with patient preferences. An insurer's ability to counter these incentives is not monotonic in how informed patients are, however. When demand is either perfectly inelastic to treatment practices because patients are completely uninformed or a sufficient proportion of the market is informed relative to the number of physicians in the market, then an insurer can induce its preferences through supply-side payment rules. Otherwise, more intensive policy levers such as utilization review must be employed. Programs that increase patient information can therefore improve the efficiency despite generating stronger incentive to treat according to patient preferences. I also explore how noisy signals of illness type and diagnostic testing further complicate the insurer's problem.

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