• Read my paper (market concentration, ACOs, antitrust, and more)

    My paper “The future of health care costs: Hospital-insurer balance of power” appears today, published by the National Institute for Health Care Management (NIHCM). It’s about 1,400 words long, roughly the length of two or three of my blog posts. Since I want you to read it, I’ll help you find the time by not posting anything else today.*

    Here’s an extract of the introduction,

    Even with the passage of the Patient Protection and Affordable Care Act (ACA), the U.S. health care system is and will remain predominantly private and market-based. […]

    Market forces, then, heavily influence the characteristics and costs of the U.S. health system. In particular, market structure defined by the degree of consolidation in the hospital and insurance industries is a key determinant of the price paid for hospital services, affecting both the revenue earned by hospitals and the costs to indemnity insurers, self-funded employer plans and policyholders. […]

    In this essay, I draw on the large and growing body of research on the history and consequences of hospital and insurer market concentration to support hypotheses about how provisions of the ACA may differentially affect hospitals, insurers and consumers in the public and private health care market sectors. I also offer suggestions for areas where antitrust policy and health economics research need more attention in order to prepare for the changes ahead.

    Find the paper and read the rest on the NIHCM site. Then, if you wish, come back here for discussion in the comments to this post.

    Acknowledgements: I’m grateful for the input provided by Rex Santerre, Cory Capps, and Julie Schoenman. Though the paper wasn’t formally peer reviewed, in effect it was by these three scholars. I also thank NIHCM for inviting me to participate in their Expert Voices series. It is flattering indeed.

    (I should mention that, coincidentally, Uwe Reinhardt makes some of the same points in a post today. His post is very good, and I’d be making a much bigger deal of it if I didn’t have my own paper coming out today.)

    * I’ll reverse myself and post again today in the event of a breaking health care economics or policy emergency for which a blog post by me is in the national interest.

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