scholarly journals Does Health Plan Generosity Enhance Hospital Market Power?

2015 ◽  
Author(s):  
Laurence Baker ◽  
M. Kate Bundorf ◽  
Daniel Kessler
Keyword(s):  
Market Power ◽  
Health Plan ◽  
Hospital Market

scholarly journals Does health plan generosity enhance hospital market power?

2015 ◽  
Vol 44 ◽  
pp. 54-62 ◽  
Author(s):  
Laurence C. Baker ◽  
M. Kate Bundorf ◽  
Daniel P. Kessler
Keyword(s):  
Market Power ◽  
Health Plan ◽  
Hospital Market

Countervailing Market Power and Hospital Competition

2021 ◽  
pp. 1-33
Author(s):  
Eric Barrette ◽  
Gautam Gowrisankaran ◽  
Robert Town
Keyword(s):  
Willingness To Pay ◽  
Market Power ◽  
Claims Data ◽  
Antitrust Policy ◽  
Healthcare Sector ◽  
Hospital Competition ◽  
Hospital Market ◽  
Economic Theories ◽  
Hospital Merger

While economic theories indicate that market power by downstream firms can potentially counteract market power upstream, antitrust policy is opaque about whether to incorporate countervailing market power in merger analyses. We use detailed national claims data from the healthcare sector to evaluate whether countervailing insurer power does indeed limit hospitals' exercise of market power. We estimate willingness-to-pay models to evaluate hospital market power across analysis areas. We find that countervailing market power is important: a typical hospital merger would raise hospital prices 4.3% at the 25th percentile of insurer concentration but only 0.97% at the 75th percentile of insurer concentration.

Covered California: The Impact of Provider and Health Plan Market Power on Premiums

2015 ◽  
Vol 40 (6) ◽  
pp. 1179-1202 ◽  
Author(s):  
Richard M. Scheffler ◽  
Eric Kessell ◽  
Margareta Brandt
Keyword(s):  
Market Power ◽  
Health Plan ◽  
The Impact

Health Plan Denials and Appeals

2008 ◽  
Vol 18 (1) ◽  
pp. 27-32
Author(s):  
Sandra Schwartz ◽  
Janet McCarty
Keyword(s):  
Health Plan ◽  
Voice Therapy ◽  
Voice Treatment ◽  
Independent Review

Abstract Challenging health plan denials for voice treatment through appeals or advocacy efforts can pay off. This article describes the process of obtaining authorization for voice therapy, filing claims, establishing goals, preparing needed documentation, appealing claims through various levels including independent review, and developing an advocacy campaign if coverage is not offered or is very limited.

Obama Health Plan Adds to Employer System

Ob Gyn News ◽  
2008 ◽  
Vol 43 (15) ◽  
pp. 38
Author(s):  
MARY ELLEN SCHNEIDER
Keyword(s):  
Health Plan

Health Plan Feedback to Physicians Improves Asthma Care

2006 ◽  
Vol 40 (9) ◽  
pp. 58
Author(s):  
JANE SALODOF MACNEIL
Keyword(s):  
Health Plan ◽  
Asthma Care

Future Uncertain as Health Plan Settlements Expire

2008 ◽  
Vol 39 (4) ◽  
pp. 54
Author(s):  
ALICIA AULT
Keyword(s):  
Health Plan

CMS Seeks to End Health Plan Marketing Abuse

2008 ◽  
Vol 39 (7) ◽  
pp. 60
Author(s):  
JANE ANDERSON
Keyword(s):  
Health Plan
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