caa a22 4500 378936255 CHVBK 20180305123641.0 cr unu---uuuuu 161128e20041214xx s 000 0 eng 10.2202/1538-0645.1240 doi (NATIONALLICENCE)gruyter-10.2202/1538-0645.1240 Pricing Coordination Failures and Health Care Provider Integration [Elektronische Daten] [Karen Eggleston, George Norman, Lynne Marie Pepall] The rise of managed healthcare organizations (MCOs) and the associated increased integration among providers has transformed US healthcare and at the same time raised antitrust concern. This paper examines how competition among MCOs affects the efficiency gains of improved price coordination achieved through integration. MCOs offer differentiated services and contract with specialized and complementary upstream providers to supply these services. We identify strategic pricing equilibria under three different market structures: overlapping upstream physician-hospital alliances, upstream-downstream arrangements such as Preferred Provider Organizations, and vertically integrated Health Maintenance Organizations. The efficiency gains achieved depend not only on organizational form but also on the toughness of premium competition. We show that, contrary to popular thinking, providers and insurers do not earn maximum net revenue when they are monopolies or monopsonies, but rather at an intermediate level of market power. Furthermore, closer integration of upstream and downstream providers does not necessarily increase net revenues. ©2011 Walter de Gruyter GmbH & Co. KG, Berlin/Boston Managed care nationallicence Antitrust nationallicence Networks nationallicence Pricing externalities nationallicence Eggleston Karen Tufts University, karene@stanford.edu aut Norman George Tufts University, george.norman@tufts.edu aut Pepall Lynne Marie Tufts University, lynne.pepall@tufts.edu aut Contributions in Economic Analysis & Policy De Gruyter 3/1(2004-12-14) 3:1 2004 3 bejeap https://doi.org/10.2202/1538-0645.1240 text/html Onlinezugriff via DOI 1 research article jats NATIONALLICENCE 856 40 https://doi.org/10.2202/1538-0645.1240 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Eggleston Karen Tufts University, karene@stanford.edu aut NATIONALLICENCE 700 1- Norman George Tufts University, george.norman@tufts.edu aut NATIONALLICENCE 700 1- Pepall Lynne Marie Tufts University, lynne.pepall@tufts.edu aut NATIONALLICENCE 773 0- Contributions in Economic Analysis & Policy De Gruyter 3/1(2004-12-14) 3:1 2004 3 bejeap CC0 http://creativecommons.org/publicdomain/zero/1.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-gruyter