TY  - JOUR
AU  - Duggan,Mark
TI  - Hospital Market Structure and the Behavior of Not-for-Profit Hospitals:  Evidence from Responses to California's Disproportionate Share Program
JF  - National Bureau of Economic Research Working Paper Series
VL  - No. 7966
PY  - 2000
Y2  - October 2000
UR  - http://www.nber.org/papers/w7966
L1  - http://www.nber.org/papers/w7966.pdf
N1  - Author contact info:
Mark Duggan
The Wharton School
University of Pennsylvania
1452 Steinberg Hall-Dietrich Hall
3620 Locust Walk
Philadelphia, PA 19104
Tel: 215-898-0928
Fax: 215-898-7635
E-Mail: mduggan@wharton.upenn.edu
AB  - I exploit a plausibly exogenous change in hospital financial incentives to examine whether the behavior of private not-for-profit hospitals varies with the share of nearby hospitals organized as for-profit firms. My results show that not-for-profit hospitals in for-profit intensive areas are significantly more responsive to an increased incentive to treat low-income patients insured by the Medicaid program than are other not-for-profit providers.  The heterogeneity in behavior is not due to differences in financial constraints but is instead likely driven by different degrees of market competitiveness in areas with one or more for-profit hospitals.  The observed variation in the governing boards of not-for-profit hospitals across market areas supports the hypothesis that increased for-profit penetration makes these facilities more profit-oriented.
ER  -