The effects of HMO and its for-profit expansion on the survival of specialized hospital services

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Authors
Shen, Yu-Chu
Subjects
HMO
Advisors
Date of Issue
2006-07
Date
Publisher
National Bureau of Economic Research
Language
Abstract
This study examines the effect of HMO and for-profit HMO share on the survival of safety net services and profitable services in hospitals. Using data from 1990-2003 and proportional hazard models, I find that hospitals in high HMO markets started out having lower hazard of shutting down services in 1990-1994 than those in low HMO markets, but their hazard rates increase over time. By 2000-2003, hospitals in high HMO markets ended up with higher risk of shutting down profitable services than those in low HMO markets. Conditional on overall HMO penetration, markets with higher for-profit share of HMOs have highr hazard of shutting down services, and the gap in survival between high and low for profit HMO markets is bigger in high HMO areas. Lastly, I find that the hazard rate of shutting down profitable services is comparable among not-for-profit, for-profit, and government hospitals, while the hazard of shutting down safety net services is the highest in for-profit hospitals and lowest in government hospitals.
Type
Book
Description
Series/Report No
Department
Business & Public Policy (GSBPP)
Organization
Monterey, California, Naval Postgraduate School
Identifiers
NPS Report Number
Sponsors
Funder
Format
Citation
NBER Working Paper No. 12374
Distribution Statement
Rights
This publication is a work of the U.S. Government as defined in Title 17, United States Code, Section 101. Copyright protection is not available for this work in the United States.
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