Young G J, Desai K R, Hellinger F J
Department of Veterans Affairs and Boston University School of Public Health, USA.
J Health Polit Policy Law. 2000 Dec;25(6):1051-81. doi: 10.1215/03616878-25-6-1051.
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.
非营利性医院受其服务社区的传统控制，一直被用作限制对涉及非营利性医院合并的反垄断执法的理由。可以说，社区是对非营利性医院以提高价格形式行使市场力量倾向的一种约束；然而，对于那些通过合并或收购成为医院系统成员的医院——尤其是那些在区域或多区域基础上运营的医院——社区控制可能会被削弱。我们报告了一项研究的结果，在该研究中，我们实证检验了基于社区控制程度可区分的三类非营利性医院的市场集中度与定价模式之间的关系：独立医院、当地医院系统的成员以及非当地医院系统的成员。研究结果表明，当存在形成更集中市场的条件时，（1）所有三类非营利性医院都以提高价格的形式行使市场力量，并且（2）非当地系统的医院在行使市场力量方面比独立医院或当地系统医院更积极。这些结果对反垄断执法政策具有重要意义。
