The Effects of Physician and Hospital Integration on Medicare Beneficiaries’ Health Outcomes

Bureau of Economics Federal Trade Commission, WP No. 337

56 Pages Posted: 13 Aug 2018

See all articles by Thomas Koch

Thomas Koch

Government of the United States of America, Federal Trade Commission, Bureau of Economics

Brett W. Wendling

Government of the United States of America - Federal Trade Commission

Nathan Wilson

Government of the United States of America - Federal Trade Commission, Bureau of Economics

Date Written: July 2018

Abstract

We consider whether hospital acquisitions of physicians lead to improved clinical outcomes for Medicare patients aged 65 and older. The analysis combines 2005-2012 Medicare fee-for-service and enrollment data with merger and physician affiliation information from the Levin Reports and SK&A, respectively. The analysis uses propensity score matching and a discrete-time hazard model to determine the effect of acquisitions on several health outcomes: mortality, acute myocardial infarctions, acute circulatory conditions, ischemic heart disease, glaucoma, symptomatic diabetes complications, and asymptomatic diabetes complications. These outcomes represent the progression of hypertension and diabetes into worse health states. Our results indicate that hospital acquisitions of existing physician practices have no statistically significant clinical benefits for the health outcomes we consider.

Keywords: Integration, Industrial Organization, Physicians, Medicare, Mortality, Diabetes, Hypertension, Health Outcomes

JEL Classification: I11, L23, L40

Suggested Citation

Koch, Thomas and Wendling, Brett W. and Wilson, Nathan, The Effects of Physician and Hospital Integration on Medicare Beneficiaries’ Health Outcomes (July 2018). Bureau of Economics Federal Trade Commission, WP No. 337. Available at SSRN: https://ssrn.com/abstract=3221282 or http://dx.doi.org/10.2139/ssrn.3221282

Thomas Koch (Contact Author)

Government of the United States of America, Federal Trade Commission, Bureau of Economics ( email )

601 Pennsylvania Avenue, NW
Washington, DC 20580
United States

Brett W. Wendling

Government of the United States of America - Federal Trade Commission ( email )

600 Pennsylvania Ave., NW
Washington, DC 20580
United States

Nathan Wilson

Government of the United States of America - Federal Trade Commission, Bureau of Economics ( email )

600 Pennsylvania Avenue, NW
Washington, DC 20580
United States
202 326 3485 (Phone)

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