We have demonstrated that when providers of health insurance are perceived to be differentiated by consumers, circumstances may arise under which they find it advantageous to restrict the set of health-care providers that they approve to their customers. Even if all health-care providers are equally qualified and efficient, payers may choose to contract with a selected subset of them in order to secure more favorable contract terms.
Gautam Gowrisankaran and Robert J. Town
We present a dynamic model of the hospital industry in which nonprofit and for-profit hospitals coexist and compete and are differentiated by their objective functions, investment technologies, and taxation rates. In our model, patients differ by income and type of insurance coverage, and choose admission to their preferred hospital, while hospitals choose investment, entry, exit, and pricing strategies.
Richard G. Frank and David S. Salkever
During the 1980s the share of prescriptions sold by retail pharmacies that was accounted for by generic products roughly doubled. The price response to generic entry of brand-name products has been a source of controversy. In this paper we estimate models of price responses to generic entry in the market for brand-name and generic drugs. We study a sample of 32 drugs that lost patent protection during the early to mid-1980s.
Reimbursement systems for health-care providers are very complex, like the production systems that they regulate. This complexity has led to some important misperceptions about the incentive consequences of major reimbursement reforms. One example is the prospective payment system (PPS), developed to provide “high-powered” incentives through fixed prices for hospital admissions for the US elderly.
William E. Encinosa III and David E. M. Sappington
We develop a model of competition among health maintenance organizations (HMOs) to analyze the effects of market power, scale economies, and asymmetric knowledge of health risk on market outcomes. We find that competition among HMOs may, but need not, ensure socially preferred outcomes.
Fiona M. Scott Morton
This paper examines the effect of the MFC rules adopted by Medicaid on both price dispersion and price levels in the wholesale pharmaceutical market. Theory suggests that the regulations should reduce price dispersion and increase the average price for those products with a high initial level of price dispersion. Using data which can only measure some dimensions of price discrimination, I find that discrimination falls for products sold to hospitals, but not drugstores.
Yeon-Koo Che and Ian Gale
In a health insurance market, a large employer or an organized “buyer alliance” is in a position to influence the design of plans offered to its members. We study how the sponsors of buyer alliances manage competition among insurance firms by focusing on their choices of the format of competition, the number of firms allowed to compete, and the quality of care offered by the firms.
This paper surveys recent work in contract theory that relates to the allocation of tasks among agents within an organization as well as to the effect of product market competition upon optimal contracting and agency costs.
Nahum Melumad, Dilip Mookherjee and Stefan Reichelstein
In settings where the revelation principle applies, delegation arrangements are frequently inferior to centralized decision making, and at best achieve the same level of performance. This paper studies the value of delegation when organizations are constrained by a bound on the number of contingencies in any contract.
David P. Baron
This paper examines the integration of market and nonmarket strategies in a setting involving market competition and international trade policy where governments serve as bargaining agents for firms. In the case modeled, the Eastman Kodak Company (Kodak) filed a Section 301 petition under US trade law against practices of Fuji Photo Film Company (Fujifilm) in the Japanese distribution system that Kodak alleges constitute trade barriers.
Marcel Boyer and Michel Moreaux
We show how technological flexibility choices and equilibrium configurations (both simultaneous and sequential duopoly) depend on six industry characteristics. Low market volatility combined with intermediate market size favors inflexible technologies; large values of either volatility or size favor flexible technologies; low or intermediate values of both favor the coexistence of flexible and inflexible technologies.
Mary K. Olson
This paper empirically examines the effect of firm-specific characteristics on the length of time required by the Food and Drug Administration (FDA) to review and approve new-drug applications between 1990 and 1992. The approach treats regulatory decisions as endogenous and explains the variation in regulatory behavior as a function of differences that exist between firms and drugs.
Y. Joseph Lin
This paper examines the incentive effects of division of labor on worker effort, in the absence of the scale effects studied by Adam Smith. The game-theoretic model gives two results. (1) Suppose workers are identical and risk-neutral, and there is stochastic observation of group output by the firm offering compensations subject to some worker-participation constraint. Then the firm can arrive at the same first-best outcome with or without division of labor.
This article investigates the issue of predation by a regulated firm. Since it has private information, a regulated firm obtains higher rents in case of successful predation: the fewer the competitors, the higher the marginal social value of the regulated firm's effort and the higher the informational rents.