Primary Care Competition and Quality of Care: Empirical Evidence from Medicare's Physician Quality Reporting System

Abstract

Using data from Medicare’s Physician Compare Quality Reporting System, we explore the effects of primary care physician (PCP) practice competition on four distinct quality metrics directly tied to screening and follow-up care. Controlling for physician and practice attributes, we find strong evidence that primary care practices in more concentrated markets are less likely to perform screening and follow- ups for blood pressure, body weight, depression, and tobacco use. These results suggest that mergers of physician practice may harm quality competition implying that antitrust merger review should not only focus on how provider mergers impact commercially insured prices but also quality for Medicare beneficiaries.

Keywords: competition, HHI, primary care, quality

JEL Classification: I11, L11