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- Title
Physician Competition in the Era of Accountable Care Organizations.
- Authors
Richards, Michael R.; Smith, Catherine T.; Graves, Amy J.; Buntin, Melinda B.; Resnick, Matthew J.
- Abstract
<bold>Objective: </bold>To calculate physician concentration levels for all U.S. markets using detailed data on integration and accountable care organization (ACO) participation.<bold>Data Source: </bold>2015 SK&A office-based physician survey linked to all commercial and public payer ACOs.<bold>Study Design: </bold>We construct three separate Herfindahl-Hirschman Index (HHI) measures and plot their distributions. We then investigate how prevailing levels of concentration change when incorporating more detailed organizational features into the HHI measure.<bold>Principal Findings: </bold>Horizontal and vertical integration strongly influences measures of physician concentration; however, ACOs have limited impact overall. ACOs are often present in competitive markets, and only in a minority of these markets do ACOs substantively increase physician concentration.<bold>Conclusions: </bold>Monitoring ACO effects on physician competition will likely have to proceed on a case-by-case basis.
- Subjects
UNITED States; ACCOUNTABLE care organizations; DATA integration; SURVEYS; MARKETS; PATIENT monitoring; MEDICINE; PHYSICIANS; PRIMARY health care; SYSTEM integration; ECONOMIC competition; IMPACT of Event Scale
- Publication
Health Services Research, 2018, Vol 53, Issue 2, p1272
- ISSN
0017-9124
- Publication type
journal article
- DOI
10.1111/1475-6773.12690