TY  - JOUR
AU  - Shen,Yu-Chu
TI  - The Effects of HMO and Its For-Profit Expansion on the Survival of Specialized Hospital Services
JF  - National Bureau of Economic Research Working Paper Series
VL  - No. 12374
PY  - 2006
Y2  - July 2006
UR  - http://www.nber.org/papers/w12374
L1  - http://www.nber.org/papers/w12374.pdf
N1  - Author contact info:
Yu-Chu Shen
Graduate School of Business and Public Policy
Naval Postgraduate School
555 Dyer Road
Monterey, CA 93943
Tel: 831/656-2951
E-Mail: yshen@nps.edu
M2  - featured in NBER digest on 2006-07-24
AB  - This study examines the effect of HMO and for-profit HMO share on the survival of safety net services and profitable services in hospitals. Using data from 1990-2003 and proportional hazard models, I find that hospitals in high HMO markets started out having lower hazard of shutting down services in 1990-1994 than those in low HMO markets, but their hazard rates increase over time. By 2000-2003, hospitals in high HMO markets ended up with higher risk of shutting down profitable services than those in low HMO markets. Conditional on overall HMO penetration, markets with higher for-profit share of HMOs have higher hazard of shutting down services, and the gap in survival between high and low for-profit HMO markets is bigger in high HMO areas. Lastly, I find that the hazard rate of shutting down profitable services is comparable among not-for-profit, for-profit, and government hospitals, while the hazard of shutting down safety net services is the highest in for-profit hospitals and lowest in government hospitals.
ER  -