Hospital Selective Contracting without Consumer Choice: What Can We Learn from Medi-Cal?.

In the selective contracting era, consumer choice has generally been absent in most state Medicaid programs, including California’s (called Medi-Cal). In a setting where beneficiary exit is not a threat, a large payer may have both the incentives and the ability to exercise undue market power, potentially exposing an already vulnerable population to further harm. The analyses presented here of Medi-Cal contracting data, however, do not yield compelling evidence in favor of the undue market power hypothesis. Instead, hospital competition appears to explain with greater consistency why certain hospitals choose to contract with Medi-Cal while others do not, the trends in inpatient prices paid by Medi-Cal over time, and the effect of price competition on service cutbacks, such as emergency room closures.

Main Author: Bamezai, Anil.
Other Authors: Melnick, Glenn A., Mann, Joyce M., Zwanziger, Jack.
Language: English
Published: 2003
Online Access: http://ezproxy.villanova.edu/login?url=https://digital.library.villanova.edu/Item/vudl:174016
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dc_source_str_mv Journal of Policy Analysis and Management 22(1), 2003, 65–84.
author Bamezai, Anil.
author_facet_str_mv Bamezai, Anil.
Melnick, Glenn A.
Mann, Joyce M.
Zwanziger, Jack.
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Melnick, Glenn A.
Mann, Joyce M.
Zwanziger, Jack.
author_s Bamezai, Anil.
spellingShingle Bamezai, Anil.
Hospital Selective Contracting without Consumer Choice: What Can We Learn from Medi-Cal?.
author-letter Bamezai, Anil.
author_sort_str Bamezai, Anil.
author2 Melnick, Glenn A.
Mann, Joyce M.
Zwanziger, Jack.
author2Str Melnick, Glenn A.
Mann, Joyce M.
Zwanziger, Jack.
dc_title_str Hospital Selective Contracting without Consumer Choice: What Can We Learn from Medi-Cal?.
title Hospital Selective Contracting without Consumer Choice: What Can We Learn from Medi-Cal?.
title_short Hospital Selective Contracting without Consumer Choice: What Can We Learn from Medi-Cal?.
title_full Hospital Selective Contracting without Consumer Choice: What Can We Learn from Medi-Cal?.
title_fullStr Hospital Selective Contracting without Consumer Choice: What Can We Learn from Medi-Cal?.
title_full_unstemmed Hospital Selective Contracting without Consumer Choice: What Can We Learn from Medi-Cal?.
collection_title_sort_str hospital selective contracting without consumer choice: what can we learn from medi-cal?.
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description In the selective contracting era, consumer choice has generally been absent in most state Medicaid programs, including California’s (called Medi-Cal). In a setting where beneficiary exit is not a threat, a large payer may have both the incentives and the ability to exercise undue market power, potentially exposing an already vulnerable population to further harm. The analyses presented here of Medi-Cal contracting data, however, do not yield compelling evidence in favor of the undue market power hypothesis. Instead, hospital competition appears to explain with greater consistency why certain hospitals choose to contract with Medi-Cal while others do not, the trends in inpatient prices paid by Medi-Cal over time, and the effect of price competition on service cutbacks, such as emergency room closures.
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dc.title Hospital Selective Contracting without Consumer Choice: What Can We Learn from Medi-Cal?.
dc.creator Bamezai, Anil.
Melnick, Glenn A.
Mann, Joyce M.
Zwanziger, Jack.
dc.description In the selective contracting era, consumer choice has generally been absent in most state Medicaid programs, including California’s (called Medi-Cal). In a setting where beneficiary exit is not a threat, a large payer may have both the incentives and the ability to exercise undue market power, potentially exposing an already vulnerable population to further harm. The analyses presented here of Medi-Cal contracting data, however, do not yield compelling evidence in favor of the undue market power hypothesis. Instead, hospital competition appears to explain with greater consistency why certain hospitals choose to contract with Medi-Cal while others do not, the trends in inpatient prices paid by Medi-Cal over time, and the effect of price competition on service cutbacks, such as emergency room closures.
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