TY  - JOUR
AU  - Kessler,Daniel P.
AU  - McClellan,Mark B.
TI  - Is Hospital Competition Socially Wasteful?
JF  - National Bureau of Economic Research Working Paper Series
VL  - No. 7266
PY  - 1999
Y2  - July 1999
UR  - http://www.nber.org/papers/w7266
L1  - http://www.nber.org/papers/w7266.pdf
N1  - Author contact info:
Daniel Kessler
Stanford University
434 Galvez Mall
Stanford, CA  94305
Tel: 650/723-0596
E-Mail: fkessler@stanford.edu

Mark B. McClellan
Director, Engelberg Center for Health Care Reform
Senior Fellow, Economic Studies
Leonard .D. Schaeffer Director's Chair in
Health Policy ,The Brookings Institution
1775 Massachusetts avenue, N.W.
Washington, DC 20036
Tel: (202) 741-6567
Fax: NA
E-Mail: mmcclellan@brookings.edu
M2  - featured in NBER digest on 2000-03-01
AB  - We study the consequences of hospital competition for Medicare beneficiaries' heart attack care from 1985 to 1994.  We examine how relatively exogenous determinants of hospital choice such as travel distances influence the competitiveness of hospital markets, and how hospital competition interacts with the influence of managed care organizations to affect the key determinants of social welfare   expenditures on treatment and patient health outcomes.  In the 1980s, the welfare effects of competition were ambiguous; but in the 1990s, competition unambiguously improves social welfare. Increasing HMO enrollment over the sample period partially explains the dramatic change in the impact of hospital competition.
ER  -