We previously raised concerns about the most recent “The Price Ain’t Right” study by a group of academic economists that attempted to link hospital concentration and price. We went a step further and asked the very experienced team of economists with Charles River Associates to take a deeper dive. These same economists, who have worked on dozens of hospital transactions, weighed in on the first study finding it seriously flawed. Not surprisingly, this update fared little better.

 

While downplayed, even the authors admit that their research doesn’t conclusively link market structure with prices and so, we’d urge, should be taken with canister of salt or at best viewed as “interesting.” Among the most obvious flaws, even to non-economists, is that its conclusions rely on a database that lacks Blue Cross Blue Shield information on contracts and prices. Even a cursory review of the latest American Medical Association data on insurer market concentration show that those plans dominate the nation’s health insurance markets. Recognizing that, the authors attempt to compensate without any success. In fact, their data show that “in markets with high BCBS share, hospital mergers are not associated with any significant change in hospital prices for Aetna, Humana, and UnitedHealth post-merger.”

 

Other flaws include findings inconsistent with the way in which hospitals’ contracts with insurers are actually negotiated and hospitals’ preferences for certain types of contracts based on discounts-off-charges. Moreover, by focusing on a single service – MRIs – instead of an entire bundle of services to evaluate prices, the authors once again fail to appreciate the dynamics involved in real-world negotiations and so their conclusions come up short once again. In contrast, a 2017 study prepared for the AHA by Charles River Associates confirmed that hospital mergers result in efficiencies, savings, innovation and quality improvements essential to transforming health care delivery, all of which benefits patients.

 

For a more real-world view of hospital transactions and the benefits to patients from greater coordination and focus on quality, see the deeper dive prepared for AHA by Charles River Associates.

 

Hatton is AHA senior vice president and General Counsel

Related News Articles

Headline
The Centers for Medicare & Medicaid Services Dec. 23 introduced a new drug pricing model for Medicare Part D and Medicaid beneficiaries. The Better…
Headline
Thank you for listening to Advancing Health! As we close out 2025, we’re excited to share highlights from two impactful episodes that sparked dialogue around…
Headline
The Centers for Medicare & Medicaid Services Dec. 19 issued two proposed rules for implementing alternative drug pricing models. The first proposed…
Headline
The White House announced Dec. 19 that it reached most-favored-nation deals with nine pharmaceutical companies, aligning their drug prices with the lowest paid…
Headline
The House Dec. 17 passed the Lower Health Care Premiums for All Americans Act (H.R. 6703), legislation to expand association health plans, increase…
Headline
The AHA Dec. 17 urged Elevance Health, which is the parent company of the Anthem brand of health plans, to rescind Anthem’s nonparticipating provider…