Journal Publication

Petris Center researchers have a new paper released in the Journal of Human Resources for Health. The paper, titled “Forecasting Imbalances in the Global Health Labor Market and Devising Policy Responses”, was co-authored by Petris Center Director Dr. Richard Scheffler and Petris Research Director Dr. Daniel Arnold, as well as researchers from the WHO, World Bank, OCED, UC Irvine, and UCSF.

The paper examines two recent key workforce reports – one done by the World Health Organization (WHO) that used a needs-based approach and one done by the World Bank that uses a labor market approach – examining how their key findings were developed, the global policy dilemmas they raise, and relevant policy solutions. The full paper can be accessed here.

Dr. Scheffler and Arnold’s new research on health care market concentration was featured in Open Minds this week, which provides daily market intelligence and industry analysis for executives in behavioral health, mental health, and social services. The Open Minds piece, titled “Insurer Market Power Lowers Hospital & Physician Payment Rates”, discusses Scheffler and Arnold’s findings as reported in their Health Affairs article “Insurer Market Power Lowers Prices In Numerous Concentrated Provider Markets”, which found that insurers have the bargaining power to reduce provider prices in highly concentrated provider markets. In particular, hospital admission prices and cardiologist, radiologist, and hematologist/oncologist visit prices were all lower.

You can access the abstract of the Open Minds article here; full text access is limited to subscribers.

Dr. Scheffler and Dr. Arnold’s new paper “Insurer Market Power Lowers Prices In Numerous Concentrated Provider Markets” was released in Health Affairs this week. The paper uses prices of hospital admissions and visits to five types of physicians to analyze how provider and insurer market concentration—as measured by the Herfindahl-Hirschman Index (HHI)—interact and are correlated with prices. Scheffler and Arnold find evidence that in the range of the Department of Justice’s and Federal Trade Commission’s definition of a moderately concentrated market (HHI of 1,500–2,500), insurers have the bargaining power to reduce provider prices in highly concentrated provider markets for cardiologist, radiologist, and hematologist/oncologist visit prices. However, a policy dilemma arises from these findings: there are no insurer market mechanisms that will pass a portion of these price reductions on to consumers in the form of lower premiums. The paper concludes that large purchasers of health insurance, such as state and federal governments, as well as the use of regulatory approaches, could provide a solution.

The September issue of Health Affairs features a collection of papers addressing health care market concentration. Earlier versions of these articles were presented at the “Impact of Healthcare Market Concentration on Healthcare Prices and Premiums: What Can and Should Be Done” conference, organized by the Petris Center, at the Robert F. Wagner Graduate School of Public Service, New York University, New York City, on April 14, 2017.

Dr. Brent Fulton’s new paper “Health Care Market Concentration Trends In The United States: Evidence And Policy Responses” was published in Health Affairs this week. Dr. Fulton’s study analyzes market concentration trends in the United States from 2010 to 2016 for hospitals, physician organizations, and health insurers, finding that hospital and physician organization markets became increasingly concentrated over this time period. Concentration among primary care physicians increased the most, partially because hospitals and health care systems acquired primary care physician organizations. The paper finds that a large number of Metropolitan Statistical Areas (MSAs) are highly concentrated – in 2016, reaching 91% for hospitals, 65% for specialist physicians, 39% for primary care physicians, and 57% for insurers. The paper concludes that public policies that enhance competition are needed, such as stricter enforcement of antitrust laws, reducing barriers to entry, and restricting anticompetitive behaviors.

The September issue of Health Affairs features a collection of papers addressing health care market concentration. Earlier versions of these articles were presented at the “Impact of Healthcare Market Concentration on Healthcare Prices and Premiums: What Can and Should Be Done” conference, organized by the Petris Center, at the Robert F. Wagner Graduate School of Public Service, New York University, New York City, on April 14, 2017.

The Petris Center has a new article published in the January issue of Health Affairs, entitled “Consumers Buy Lower-Cost Plans on Covered California, Suggesting Exposure to Premium Increases Less than Commonly Reported.” The paper was authored by the Petris Center’s Graduate Student Researcher Daniel Arnold, Dr. Brent Fulton, and Dr. Scheffler, along with Jon Gabel and researchers from NORC.

The full article can be read on Health Affair’s website here.

A new article by the Petris Center’s Dr. Scheffler, Dr. Fulton, and Researcher Daniel Arnold – “Consumers Buy Lower-Cost Plans on Covered California Suggesting Premium Increases Are Less than Commonly Reported” – was accepted for publication by Health Affairs. This piece was authored along with Jon Gabel, Heidi Whitmore, Samuel Stromberg, and Matthew Green from NORC at the University of Chicago.

More information on the article is forthcoming.

Dr. Scheffler, Dr. Fulton, and Graduate Researcher Daniel Arnold, along with Dr. Sherry Glied of New York University, have a newly published paper in Health Affairs this week. The paper, “Differing Impacts Of Market Concentration On Affordable Care Act Marketplace Premiums,”examines recent increases in market concentration among health plans, hospitals, and medical groups in order to see the impact of these mergers on consumer’s costs. Specifically, the impact of concentration on health insurance premiums was examined in two Affordable Care Act state-based marketplaces: Covered California and NY State of Health, both for 2014-2015. Ultimately, the paper finds that both states exhibited a positive association between hospital concentration and premium growth and a positive (but not statistically significant) association between medical group concentration and premium growth, but differed between the two states, with premium growth in New York yet negative premium growth in California, potentially the result of the marketplace’s selectively contracting with health plans.

The full paper can be read on the Health Affairs website here.

Professor Scheffler is the editor of a just released 3-volume Global Health Policy and Economics Handbook through World Scientific Publishing. The official launch was January 3, 2016 at the American Economics Association meeting in San Francisco.

To learn more about the handbook, the topics it covers, and the authors, please visit here.

The University of Chicago School of Social Service Administration issued an announcement on the release of the “Assessing Accountable Care Organizations: Cost, Quality, and Market Power” special issue of the Journal of Health Politics, Policy and Law (volume 40, issue 4). The special issue is “an in-depth look at accountable care organizations (ACOs): networks of hospitals, physicians, or other health care providers that share financial and medical responsibility for the coordinated care of a patient.” The special issue was co-edited by Colleen M. Grogan, editor of JHPPL, Professor; Co-Chair, Center for Health Administration Studies; Faculty Chair, Graduate Program in Health Administration and Policy; Editor, Journal of Health Politics, Policy and Law at the University of Chicago and by Richard M. Scheffler, Director of the Petris Center, with much of the content supported through the Nicholas C. Petris Center, with funding from the California Attorney General’s office.

Read the full press release here.

The full journal article can be accessed here.