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Community Control and Pricing Patterns of Nonprofit Hospitals: An Antitrust Analysis
Traditional control of nonprofit hospitals by the communities they serve has been offered as justification for restraining antitrust enforcement of mergers that involve nonprofit hospitals. The community is arguably a constraint on a nonprofit's inclination to exercise market power in the form...
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| Published in: | Journal of health politics, policy and law policy and law, 2000-12, Vol.25 (6), p.1051-1081 |
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| Main Authors: | , , |
| Format: | Article |
| Language: | English |
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| cited_by | cdi_FETCH-LOGICAL-c509t-b2133e975787f44910e560307adc7b25dbd7ba488bd225a89066b7de69ef01933 |
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| cites | cdi_FETCH-LOGICAL-c509t-b2133e975787f44910e560307adc7b25dbd7ba488bd225a89066b7de69ef01933 |
| container_end_page | 1081 |
| container_issue | 6 |
| container_start_page | 1051 |
| container_title | Journal of health politics, policy and law |
| container_volume | 25 |
| creator | Young, Gary J. Desai, Kamal R. Hellinger, Fred J. |
| description | Traditional control of nonprofit hospitals by the communities they serve has been offered as justification for restraining antitrust enforcement of mergers that involve nonprofit hospitals. The community is arguably a constraint on a nonprofit's inclination to exercise market power in the form of higher prices; however, community control is likely to be attenuated for hospitals that through merger or acquisition become members of hospital systems-particularly those that operate on a regional or multiregional basis. We report findings from a study in which we examined empirically the relationship between market concentration and pricing patterns for three types of nonprofit hospitals that are distinguishable based on degree of community control: an independent hospital, a member of a local hospital system, and a member of a nonlocal hospital system. Study results indicated that when conditions existed to create a more concentrated market, (1) all three types of nonprofit hospitals exercised market power in the form of higher prices,and (2) hospitals that were members of nonlocal systems were more aggressive in exercising market power than were either independent or local system hospitals. The results have important implications for antitrust enforcement policy. |
| doi_str_mv | 10.1215/03616878-25-6-1051 |
| format | article |
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The community is arguably a constraint on a nonprofit's inclination to exercise market power in the form of higher prices; however, community control is likely to be attenuated for hospitals that through merger or acquisition become members of hospital systems-particularly those that operate on a regional or multiregional basis. We report findings from a study in which we examined empirically the relationship between market concentration and pricing patterns for three types of nonprofit hospitals that are distinguishable based on degree of community control: an independent hospital, a member of a local hospital system, and a member of a nonlocal hospital system. Study results indicated that when conditions existed to create a more concentrated market, (1) all three types of nonprofit hospitals exercised market power in the form of higher prices,and (2) hospitals that were members of nonlocal systems were more aggressive in exercising market power than were either independent or local system hospitals. The results have important implications for antitrust enforcement policy.</description><identifier>ISSN: 0361-6878</identifier><identifier>EISSN: 1527-1927</identifier><identifier>DOI: 10.1215/03616878-25-6-1051</identifier><identifier>PMID: 11142052</identifier><identifier>CODEN: JHPLDN</identifier><language>eng</language><publisher>United States: Duke University Press</publisher><subject><![CDATA[Acquisitions & mergers ; Anti-trust legislation ; Antitrust ; Antitrust Laws ; California ; Catchment Area (Health) ; Communities ; Community ; Community Participation ; Community-Institutional Relations - economics ; Competition ; Consumers ; Cost control ; Decision Making, Organizational ; Economic Competition - statistics & numerical data ; Economic concentration ; Economic models ; Economic theory ; Enforcement ; Governing Board - organization & administration ; Health Care Sector - statistics & numerical data ; Health Care Services ; Health Facility Merger - economics ; Health Services Research ; Hospital Charges ; Hospital systems ; Hospitals ; Hospitals, Voluntary - economics ; Hospitals, Voluntary - organization & administration ; Market share ; Markets ; Medicine and Health ; Mergers ; Models, Econometric ; Monopolies ; Multi-Institutional Systems - economics ; Multi-Institutional Systems - organization & administration ; Non-profit organizations ; Nonprofit hospitals ; Nonprofit Organizations ; Organizational Objectives ; Political Science ; Politics ; Prices ; Pricing ; Pricing policies ; Profits ; Public Health and Health Policy ; Public Policy ; Studies]]></subject><ispartof>Journal of health politics, policy and law, 2000-12, Vol.25 (6), p.1051-1081</ispartof><rights>Copyright © 2000 Duke University Press.</rights><rights>Copyright Duke University Press Dec 2000</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c509t-b2133e975787f44910e560307adc7b25dbd7ba488bd225a89066b7de69ef01933</citedby><cites>FETCH-LOGICAL-c509t-b2133e975787f44910e560307adc7b25dbd7ba488bd225a89066b7de69ef01933</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27866,27924,27925,33223,33224,33774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11142052$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Young, Gary J.</creatorcontrib><creatorcontrib>Desai, Kamal R.</creatorcontrib><creatorcontrib>Hellinger, Fred J.</creatorcontrib><title>Community Control and Pricing Patterns of Nonprofit Hospitals: An Antitrust Analysis</title><title>Journal of health politics, policy and law</title><addtitle>J Health Polit Policy Law</addtitle><description>Traditional control of nonprofit hospitals by the communities they serve has been offered as justification for restraining antitrust enforcement of mergers that involve nonprofit hospitals. The community is arguably a constraint on a nonprofit's inclination to exercise market power in the form of higher prices; however, community control is likely to be attenuated for hospitals that through merger or acquisition become members of hospital systems-particularly those that operate on a regional or multiregional basis. We report findings from a study in which we examined empirically the relationship between market concentration and pricing patterns for three types of nonprofit hospitals that are distinguishable based on degree of community control: an independent hospital, a member of a local hospital system, and a member of a nonlocal hospital system. Study results indicated that when conditions existed to create a more concentrated market, (1) all three types of nonprofit hospitals exercised market power in the form of higher prices,and (2) hospitals that were members of nonlocal systems were more aggressive in exercising market power than were either independent or local system hospitals. The results have important implications for antitrust enforcement policy.</description><subject>Acquisitions & mergers</subject><subject>Anti-trust legislation</subject><subject>Antitrust</subject><subject>Antitrust Laws</subject><subject>California</subject><subject>Catchment Area (Health)</subject><subject>Communities</subject><subject>Community</subject><subject>Community Participation</subject><subject>Community-Institutional Relations - economics</subject><subject>Competition</subject><subject>Consumers</subject><subject>Cost control</subject><subject>Decision Making, Organizational</subject><subject>Economic Competition - statistics & numerical data</subject><subject>Economic concentration</subject><subject>Economic models</subject><subject>Economic theory</subject><subject>Enforcement</subject><subject>Governing Board - organization & administration</subject><subject>Health Care Sector - statistics & numerical data</subject><subject>Health Care Services</subject><subject>Health Facility Merger - economics</subject><subject>Health Services Research</subject><subject>Hospital Charges</subject><subject>Hospital systems</subject><subject>Hospitals</subject><subject>Hospitals, Voluntary - economics</subject><subject>Hospitals, Voluntary - organization & administration</subject><subject>Market share</subject><subject>Markets</subject><subject>Medicine and Health</subject><subject>Mergers</subject><subject>Models, Econometric</subject><subject>Monopolies</subject><subject>Multi-Institutional Systems - economics</subject><subject>Multi-Institutional Systems - organization & administration</subject><subject>Non-profit organizations</subject><subject>Nonprofit hospitals</subject><subject>Nonprofit Organizations</subject><subject>Organizational Objectives</subject><subject>Political Science</subject><subject>Politics</subject><subject>Prices</subject><subject>Pricing</subject><subject>Pricing policies</subject><subject>Profits</subject><subject>Public Health and Health Policy</subject><subject>Public Policy</subject><subject>Studies</subject><issn>0361-6878</issn><issn>1527-1927</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>7TQ</sourceid><sourceid>7UB</sourceid><sourceid>8BJ</sourceid><sourceid>BHHNA</sourceid><recordid>eNqFkl-L1DAUxYMo7rj6BXyQ4oNv1dybJml8W4bVXVh0wfU5pG0qGdtmzJ-H-famzLgrgmwIJJDfufeEcwl5DfQ9IPAPlAkQrWxr5LWogXJ4QjbAUdagUD4lmxWoV-KMvIhxR8tiIJ6TMwBokHLckLutn-e8uHSotn5JwU-VWYbqNrjeLT-qW5OSDUus_Fh98cs--NGl6srHvUtmih-ri6Xs5FLIMZWbmQ7RxZfk2Vhe7avTeU6-f7q8217VN18_X28vbuqeU5XqDoExqySXrRybRgG1XFBGpRl62SEfukF2pmnbbkDkplVUiE4OVig7UlCMnZN3x7rF169sY9Kzi72dJrNYn6OWyBFVA4-CgnLJgeGjIGuV4KxZwbf_gDufQ_l_1MiQS1XcFgiPUB98jMGOeh_cbMJBA9VrhPpPhBq5FnqNsIjenCrnbrbDg-SUWQHYfeud7dOco33oDrz409_WMVingIJYq4qi4kfVkH_avA82xr9E_7fzGzvptS0</recordid><startdate>20001201</startdate><enddate>20001201</enddate><creator>Young, Gary J.</creator><creator>Desai, Kamal R.</creator><creator>Hellinger, Fred J.</creator><general>Duke University Press</general><general>Duke University Press, NC & IL</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TQ</scope><scope>7U3</scope><scope>7U4</scope><scope>7UB</scope><scope>8BJ</scope><scope>BHHNA</scope><scope>DHY</scope><scope>DON</scope><scope>DWI</scope><scope>FQK</scope><scope>JBE</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>WZK</scope><scope>7X8</scope></search><sort><creationdate>20001201</creationdate><title>Community Control and Pricing Patterns of Nonprofit Hospitals: An Antitrust Analysis</title><author>Young, Gary J. ; Desai, Kamal R. ; Hellinger, Fred J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c509t-b2133e975787f44910e560307adc7b25dbd7ba488bd225a89066b7de69ef01933</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Acquisitions & mergers</topic><topic>Anti-trust legislation</topic><topic>Antitrust</topic><topic>Antitrust Laws</topic><topic>California</topic><topic>Catchment Area (Health)</topic><topic>Communities</topic><topic>Community</topic><topic>Community Participation</topic><topic>Community-Institutional Relations - economics</topic><topic>Competition</topic><topic>Consumers</topic><topic>Cost control</topic><topic>Decision Making, Organizational</topic><topic>Economic Competition - statistics & numerical data</topic><topic>Economic concentration</topic><topic>Economic models</topic><topic>Economic theory</topic><topic>Enforcement</topic><topic>Governing Board - organization & administration</topic><topic>Health Care Sector - statistics & numerical data</topic><topic>Health Care Services</topic><topic>Health Facility Merger - economics</topic><topic>Health Services Research</topic><topic>Hospital Charges</topic><topic>Hospital systems</topic><topic>Hospitals</topic><topic>Hospitals, Voluntary - economics</topic><topic>Hospitals, Voluntary - organization & administration</topic><topic>Market share</topic><topic>Markets</topic><topic>Medicine and Health</topic><topic>Mergers</topic><topic>Models, Econometric</topic><topic>Monopolies</topic><topic>Multi-Institutional Systems - economics</topic><topic>Multi-Institutional Systems - organization & administration</topic><topic>Non-profit organizations</topic><topic>Nonprofit hospitals</topic><topic>Nonprofit Organizations</topic><topic>Organizational Objectives</topic><topic>Political Science</topic><topic>Politics</topic><topic>Prices</topic><topic>Pricing</topic><topic>Pricing policies</topic><topic>Profits</topic><topic>Public Health and Health Policy</topic><topic>Public Policy</topic><topic>Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Young, Gary J.</creatorcontrib><creatorcontrib>Desai, Kamal R.</creatorcontrib><creatorcontrib>Hellinger, Fred J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PAIS Index</collection><collection>Social Services Abstracts</collection><collection>Sociological Abstracts (pre-2017)</collection><collection>Worldwide Political Science Abstracts</collection><collection>International Bibliography of the Social Sciences (IBSS)</collection><collection>Sociological Abstracts</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><collection>Sociological Abstracts</collection><collection>International Bibliography of the Social Sciences</collection><collection>International Bibliography of the Social Sciences</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Sociological Abstracts (Ovid)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of health politics, policy and law</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Young, Gary J.</au><au>Desai, Kamal R.</au><au>Hellinger, Fred J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Community Control and Pricing Patterns of Nonprofit Hospitals: An Antitrust Analysis</atitle><jtitle>Journal of health politics, policy and law</jtitle><addtitle>J Health Polit Policy Law</addtitle><date>2000-12-01</date><risdate>2000</risdate><volume>25</volume><issue>6</issue><spage>1051</spage><epage>1081</epage><pages>1051-1081</pages><issn>0361-6878</issn><eissn>1527-1927</eissn><coden>JHPLDN</coden><abstract>Traditional control of nonprofit hospitals by the communities they serve has been offered as justification for restraining antitrust enforcement of mergers that involve nonprofit hospitals. The community is arguably a constraint on a nonprofit's inclination to exercise market power in the form of higher prices; however, community control is likely to be attenuated for hospitals that through merger or acquisition become members of hospital systems-particularly those that operate on a regional or multiregional basis. We report findings from a study in which we examined empirically the relationship between market concentration and pricing patterns for three types of nonprofit hospitals that are distinguishable based on degree of community control: an independent hospital, a member of a local hospital system, and a member of a nonlocal hospital system. Study results indicated that when conditions existed to create a more concentrated market, (1) all three types of nonprofit hospitals exercised market power in the form of higher prices,and (2) hospitals that were members of nonlocal systems were more aggressive in exercising market power than were either independent or local system hospitals. The results have important implications for antitrust enforcement policy.</abstract><cop>United States</cop><pub>Duke University Press</pub><pmid>11142052</pmid><doi>10.1215/03616878-25-6-1051</doi><tpages>31</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0361-6878 |
| ispartof | Journal of health politics, policy and law, 2000-12, Vol.25 (6), p.1051-1081 |
| issn | 0361-6878 1527-1927 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_72522941 |
| source | EconLit s plnými texty; International Bibliography of the Social Sciences (IBSS); Business Source Ultimate【Trial: -2024/12/31】【Remote access available】; Project Muse:Jisc Collections:Project MUSE Journals Agreement 2024:Premium Collection; PAIS Index; Worldwide Political Science Abstracts; Sociological Abstracts |
| subjects | Acquisitions & mergers Anti-trust legislation Antitrust Antitrust Laws California Catchment Area (Health) Communities Community Community Participation Community-Institutional Relations - economics Competition Consumers Cost control Decision Making, Organizational Economic Competition - statistics & numerical data Economic concentration Economic models Economic theory Enforcement Governing Board - organization & administration Health Care Sector - statistics & numerical data Health Care Services Health Facility Merger - economics Health Services Research Hospital Charges Hospital systems Hospitals Hospitals, Voluntary - economics Hospitals, Voluntary - organization & administration Market share Markets Medicine and Health Mergers Models, Econometric Monopolies Multi-Institutional Systems - economics Multi-Institutional Systems - organization & administration Non-profit organizations Nonprofit hospitals Nonprofit Organizations Organizational Objectives Political Science Politics Prices Pricing Pricing policies Profits Public Health and Health Policy Public Policy Studies |
| title | Community Control and Pricing Patterns of Nonprofit Hospitals: An Antitrust Analysis |
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