The effects of physician vertical integration on referral patterns, patient welfare, and market dynamics

• 成果类型: Article
• 署名作者: Whaley, Christopher M.; Zhao, Xiaoxi
• 署名单位: Brown University; Boston University; RAND Corporation
• 刊物名称: JOURNAL OF PUBLIC ECONOMICS
• ISSN/ISSBN: 0047-2727
• DOI: 10.1016/j.jpubeco.2024.105175
• 发表日期: 2024
• 关键词: Vertical Integration; Referral patterns; Market concentration

摘要

The growth of physician vertical integration raises concerns about distorted referral patterns, higher spending, and market foreclosure. Using 100% Medicare data, we combine reduced-form analysis with a discrete choice model to estimate the effects of physician vertical integration on patients' provider choices and welfare for two common downstreamsurgical procedures. Physician-hospital integration results in an approximately 10% increase in referrals to higher-priced facilities instead of lower-priced providers. Our counterfactual analysis implies that if all primary care physicians become integrated, total Medicare spending will increase by $315 million.