Patrick Michael Plummer
Penn State University, USA
Title: The impact of competition on per-day and per-case charges in healthcare
Biography
Biography: Patrick Michael Plummer
Abstract
This analysis focuses on the impact of 5-digit ZIP-code level competition on U.S.-based acute-care hospital charges per case and charges per day. Similar to FTC horizontal merger guidelines that use the Herfindahl-Hirschman Index (“HHI”) of concentration for competitive significance, this analysis identifies where firms (competitors) in the candidate market (the ZIP code) have charges per-day or charges per-case that impose at least a small but significant and non-transitory increase in price (“SSNIP”) of five percent or more above the mean charges experiences by all ZIP code cases. This study uses 2017-to-present-day data from multiple sources. The analysis suggests that there is an increase in patient charges as the number of competitors (standalone or system-aggregated) decreases in all geographical market sizes, including metropolitan (50,000+ population), micropolitan (10,000-50,000) and rural (<10,000) analysis areas.