The effects of hospital competition and the Medicare PPS program on hospital cost behavior in California

Zwanziger, Jack; Melnick, Glenn

doi:10.1016/0167-6296(88)90018-5

Cited by 240 publications

(156 citation statements)

References 10 publications

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“…At the same time, unnecessary duplication of services may cause the quality of care to drop as providers fail to take advantage of the scale of learning effect9 (Robinson and Luft 1985;Robinson 1988;Hersch 1984;Luft et al 1986). Zwanziger and Melnick (1988) find evidence consistent with the MAR hypothesis and infer that, as a result, hospitals compete on quality instead of price.…”

Section: Previous Researchsupporting

confidence: 74%

Market Concentration, Efficiency, and Quality in the Japanese Home Help Industry

Zhou¹,

Suzuki²

2006

Health Care Issues in the United States and Japan

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Section: Previous Researchsupporting

confidence: 74%

Market Concentration, Efficiency, and Quality in the Japanese Home Help Industry

Zhou¹,

Suzuki²

2006

Health Care Issues in the United States and Japan

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“…The specific algorithms used are described in detail in Zwanziger, Melnick, and Mann (1990) and Zwanziger and Melnick (1988). The HHIs calculated in this manner assume that the hospitals are all independent.…”

Section: Hmo and Hospital Market Powermentioning

confidence: 99%

Has Competition Lowered Hospital Prices?

Zwanziger

Mooney

2005

INQUIRY

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On Jan. 1, 1997, New York ended its regulation of hospital prices with the intent of using competitive markets to control prices and increase efficiency. This paper uses data that come from annual reports filed by all health maintenance organizations (HMOs) operating in New York and include payments to and usage in the major hospitals in an HMO's network. We estimate the relationship between implied prices and hospital, plan, and market characteristics. The models show that after 1997, hospitals in more competitive markets paid less. Partially offsetting these price reductions were price increases associated with hospital mergers that reduced the competitiveness of the local market. Hospital deregulation was successful, at least in the short run, in using price competition to reduce hospital payments; it is unclear whether this success will be undermined by the structural changes taking place in the hospital industry.

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“…12 The recent work of Jack Zwanziger and Glenn Melnick suggests that selective contracting can reduce the rates of increase in health care costs. 13 Finally, the work Paul Feldstein and colleagues have done on utilization review suggests that at least some such mechanisms may be effective in reducing health care costs. 14 However, U.S. labor markets are competitive, and real wages will increase as an aging population and limited immigration shrink the work force.…”

Section: Insights For Policymakersmentioning

confidence: 99%