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Market structure and hospital–insurer bargaining in the Netherlands

In 2005, competition was introduced in part of the hospital market in the Netherlands. Using a unique dataset of transactions and list prices between hospitals and insurers in the years 2005 and 2006, we estimate the influence of buyer and seller concentration on the negotiated prices. First, we use...

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Autores principales: Halbersma, R. S., Mikkers, M. C., Motchenkova, E., Seinen, I.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer-Verlag 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3197939/
https://www.ncbi.nlm.nih.gov/pubmed/20853127
http://dx.doi.org/10.1007/s10198-010-0273-z
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author Halbersma, R. S.
Mikkers, M. C.
Motchenkova, E.
Seinen, I.
author_facet Halbersma, R. S.
Mikkers, M. C.
Motchenkova, E.
Seinen, I.
author_sort Halbersma, R. S.
collection PubMed
description In 2005, competition was introduced in part of the hospital market in the Netherlands. Using a unique dataset of transactions and list prices between hospitals and insurers in the years 2005 and 2006, we estimate the influence of buyer and seller concentration on the negotiated prices. First, we use a traditional structure–conduct–performance model (SCP-model) along the lines of Melnick et al. (J Health Econ 11(3): 217–233, 1992) to estimate the effects of buyer and seller concentration on price–cost margins. Second, we model the interaction between hospitals and insurers in the context of a generalized bargaining model similar to Brooks et al. (J Health Econ 16: 417–434, 1997). In the SCP-model, we find that the market shares of hospitals (insurers) have a significantly positive (negative) impact on the hospital price–cost margin. In the bargaining model, we find a significant negative effect of insurer concentration, but no significant effect of hospital concentration. In both models, we find a significant impact of idiosyncratic effects on the market outcomes. This is consistent with the fact that the Dutch hospital sector is not yet in a long-run equilibrium.
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spelling pubmed-31979392011-11-10 Market structure and hospital–insurer bargaining in the Netherlands Halbersma, R. S. Mikkers, M. C. Motchenkova, E. Seinen, I. Eur J Health Econ Original Paper In 2005, competition was introduced in part of the hospital market in the Netherlands. Using a unique dataset of transactions and list prices between hospitals and insurers in the years 2005 and 2006, we estimate the influence of buyer and seller concentration on the negotiated prices. First, we use a traditional structure–conduct–performance model (SCP-model) along the lines of Melnick et al. (J Health Econ 11(3): 217–233, 1992) to estimate the effects of buyer and seller concentration on price–cost margins. Second, we model the interaction between hospitals and insurers in the context of a generalized bargaining model similar to Brooks et al. (J Health Econ 16: 417–434, 1997). In the SCP-model, we find that the market shares of hospitals (insurers) have a significantly positive (negative) impact on the hospital price–cost margin. In the bargaining model, we find a significant negative effect of insurer concentration, but no significant effect of hospital concentration. In both models, we find a significant impact of idiosyncratic effects on the market outcomes. This is consistent with the fact that the Dutch hospital sector is not yet in a long-run equilibrium. Springer-Verlag 2010-09-19 2011 /pmc/articles/PMC3197939/ /pubmed/20853127 http://dx.doi.org/10.1007/s10198-010-0273-z Text en © The Author(s) 2010 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
spellingShingle Original Paper
Halbersma, R. S.
Mikkers, M. C.
Motchenkova, E.
Seinen, I.
Market structure and hospital–insurer bargaining in the Netherlands
title Market structure and hospital–insurer bargaining in the Netherlands
title_full Market structure and hospital–insurer bargaining in the Netherlands
title_fullStr Market structure and hospital–insurer bargaining in the Netherlands
title_full_unstemmed Market structure and hospital–insurer bargaining in the Netherlands
title_short Market structure and hospital–insurer bargaining in the Netherlands
title_sort market structure and hospital–insurer bargaining in the netherlands
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3197939/
https://www.ncbi.nlm.nih.gov/pubmed/20853127
http://dx.doi.org/10.1007/s10198-010-0273-z
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