the rise in takeover premiums abstract cash tender cash merger and stock merger takeover premiums for 1974 1985 are approximately bouble those for 1963 1973 cash tender repurchase premiums also rose in 1974 thse upward shifts remain after we control for the business cycle and a possible time trend in premiums the shift in both takeover and repurchase premiums in 1973 1974 is consistent with some event not unique to the takeover market affecting the capital markets in 1973 1974 we also investigate the possible effect on takeover premiums of the 1986 williams act and conclude that it does not explain the premium increase

the effects of regulation and competition in the nhs internal market the case of general practice fundholder prices the 1989 reforms of the uk national health service introduced competition in supply within a tightly regulated framework the paper examines whether this competition affects the prices posted by sellers of medical services we argue that despite regulation market forces may have an impact on price we test this using the posted prices for one of the two types of buyer general practice fundholders we find the regulatory rules are not observed and some evidence of the impact of market forces on price

market structure and prices the responses of hospitals in the uk national health service to competition abstract the internal market reforms to the uk national health service nhs are a model adopted in many health care systems they introduce competition in supply little is known about the impact of these reforms this paper examines the pricing responses of nhs suppliers to competition the incentives of the reformed system are analysed these indicate that prices should differ between buyers and markets these hypotheses are tested using data on spot market transactions between hospitals and health care buyers the results indicate considerable price variability but offer broad support for the hypotheses

the impact of hospital market structure on patient volume average length of stay and the cost of care a variety of recent proposals rely heavily on market forces as a means of controlling hospital cost inflation sceptics argue however that increased competition might lead to cost increasing acquisitions of specialized clinical services and other forms of non price competition as means of attracting physicians and patients using data from hospitals in 1972 we analyzed the impact of market structure on average hospital costs measured in terms of both cost per patient and cost per patient day under the retrospective reimbursement system in place at the time hospitals in more competitive environments exhibited significantly higher costs of production than did those in less competitive environments

nonprofit hospital mergers and the exercise of market power government challenges to mergers within the hospital industry have become more frequent many of those mergers involve nonprofit organizations rather than the for profit firms that are the norm in most other industries this difference in ownership has made no apparent difference in the antitrust agencies approach to proposed hospital mergers in this article i test the proposition that nonprofit and for profit hospitals price differently in response to the structure of the markets in which they compete based on a cross sectional analysis of california hospitals i find that estimated merger effects on hospital prices do vary by type of ownership in response to either higher market share or to the joint combination of higher share and higher market concentration private nonprofit hospital prices are statistically significantly lower than for profit hospital prices and on balance in this sample there is no evidence of any systematic price increasing effect on private nonprofit hospitals

price and concentration in hospital markets the switch from patient driven to payer driven competition perhaps the most widely accepted paradigm of industrial organization i o is that competition lowers prices or alternatively that price cost margins are lower in less concentrated markets 1 the applicability of this paradigm for hospital markets has been questioned for example in united states vs carilion health system and roanoke valley hospital the district and appellate courts accepted evidence that hospital prices are lower in more concentrated markets and thereby approved a merger between the two largest hospitals in a three hospital market 2 the view that competition has a weak or perverse effect on hospital prices is shared by a number of researchers 3 is a common theme in newspaper stories

the role of hospital competition on treatment expenditure and outcome evidence from stroke and cardiac treatment in taiwan this article examines whether market competition affects treatment expenditure and health outcomes of stroke and cardiac treatment in taiwan our measure of treatment expenditure is the hospital expenditure paid at the index admission short term and the sum of inpatient and outpatient expenditures paid in the subsequent year long term our measure of health outcome is the probability of death in 1 and 12 months after the hospital s discharge our measure of competition follows the method developed by kessler and mcclellan that calculates the herfindal index based on the predicted patient flows using exogenous variables e g traveling distance to hospitals using data of patients hospitalized for new stroke and cardiac treatment between 1997 and 2001 in taiwan we find that an increase of market competition results in an insignificant impact on a patient s mortality in terms of treatment expenditure our results indicate that hospitals facing more competition incur higher expenditures either the short or long term expenditure finally we find evidence showing that an increase of treatment expenditure at admission is due to a raise of length of stay and treatment intensity per day as well as the usage of expensive equipment jel i11 l13 l41

control premiums minority discounts and optimal judicial valuation abstract this article characterizes controlling and minority share prices and optimal appraisal remedy valuation rules in a rational expectations equilibrium the model identifies a set of optimal judicial valuation policies that would motivate shareholders to make optimal investment and freeze out choices and identifies consequences of judicial valuation error the model suggests that the share appraisal rule under which minority shares are assessed a minority discount in freeze out appraisals would be more optimal than delaware s pro rata doctrine which forbids discounting of minority shares in accordance with the share appraisal rule and in contradiction with their own pro rata doctrine delaware courts frequently allow implicit discounts to minority shares in freeze out appraisals in summary the model articulates why courts should not equate minority share value with market price consistent with this implication delaware courts have always uniformly rejected the notion that market price should

competition in nhs quasi markets recent reforms of the national health service have focused attention on contracts for health services and competition amongst the providers of those services as means of ensuring that quality is maintained at an acceptable standard whilst costs are contained this paper considers the particular roles that competition may be expected to play in both health authority and gp fundholder quasi markets copyright 1996 by oxford university press

can empirical demand models assist in con comparative reviews a case study in florida certificate of need con programs for new hospital construction are intended to foster the best selection among competing hospital applications given demands for hospital care in the community yet the merits of con depend in part on the quality of the comparative review process this article examines a case study in florida to illustrate the utility of empirical evaluations using patient choice models i estimate such models to show how patients would respond to a change in hospital choices by simulating the welfare effects of the proposed hospitals i can further predict how prices of hospital care differ by applicant results suggest that empirical analysis using data on patient choice of hospitals may better inform the review process at the same time however it may not give a unique ranking without additional analysis of the fixed costs of proposed services in the context of existing marketwide capacity

managed care s price bargaining with hospitals research has shown that managed care mc slowed the rate of growth in health care spending in the 1990s primarily via lower unit prices paid however the mechanism of mc s price bargaining has not been well studied this article uses a unique panel dataset with actual hospital prices in massachusetts between 1994 and 2000 to examine the sources of mc s bargaining power i find two significant determinants of price discounts first plans with large memberships are able to extract volume discounts across hospitals second health plans that are more successful at channeling patients can extract greater discounts patient channeling can add to the volume discount that plans negotiate

relative price changes as a tool to stimulate more healthy food choices a danish household panel study abstract the increased prevalence of lifestyle related illnesses particularly in western countries calls for public action a poor diet is a key explanatory factor to this development previous research has addressed the problem of unhealthy food consumption behavior by looking at how taxes may function as an instrument to change purchase behavior from less healthy products to healthier ones in this paper we address this issue by looking at the effects of discounts depending on whether healthy or less healthy products are available at a discount our study is based on weekly purchase data from a danish household panel for the period 2010 2011 interestingly from a public health perspective our findings suggest that there is an asymmetric effect of discounts depending on the fat content of the product furthermore our results point at two classes of consumers where the asymmetric effects go in different directions

does competition between hospitals improve the quality of care hospital death rates and the nhs internal market payer driven competition has been widely advocated as a means of increasing efficiency in health care markets the 1990s reforms to the uk health service followed this path we examine whether competition led to better outcomes for patients as measured by death rates after treatment following heart attacks using data that until 1999 was not publicly available in any form on hospital level death rates we find that the relationship between competition and quality of care appears to be negative greater competition is associated with higher death rates controlling for patient mix and other observed characteristics of the hospital and the catchment area for its patients however the estimated impact of competition is small jel classification i1 l8 h4

efficient and inefficient sales of corporate control this paper develops a framework for analyzing transactions that transfer a company s controlling block from an existing controller to a new controller this framework is used to compare the market rule which is followed in the united states with the equal opportunity rule which is used in many other countries the market rule is superior to the equal opportunity rule in facilitating efficient transfers of control but inferior to it in discouraging inefficient transfers conditions under which one of the two rules is overall superior are identified for example the market rule is superior if existing and new controllers draw their characteristics from the same distributions finally the rules effects on surplus division are analyzed and this examination reveals a rationale for mandatory rules

pricing by non profit institutions the case of hospital cost shifting abstract this paper shows that a hospital whose objective function includes output as well as profits may raise price to private paying patients in response to cuts in the price it receives for madicaid or medicaid patients evidence is presented to show that hospitals in illinois cost shifted in this manner in response to substantial reductions in medicaid payments in the early 1980s as private sector pricing becomes more competitive however the ability and willingness of hospitals to cost shift will wane

competition among hospitals the traditional view of hospital competition has posited that hospitals compete primarily along quality dimensions in the form of fancy equipment to attract admitting physicians and pleasant surroundings to entice patients price competition among hospitals is thought to be non existent this paper estimates the effects of various hospital market characteristics on hospital prices and expenses in an attempt to determine the form of hospital competition the results suggest that both price and quality competition are greater in markets that are less concentrated although the net effect of the two on prices is insignificant it appears therefore that despite important distortions hospital markets are not immune to standard competitive forces

is hospital competition socially wasteful 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

the long term effects of price promotions on category incidence brand choice and purchase quantity abstract to what extent do price promotions have a long term effect on the components of brand sales namely category incidence brand choice and purchase quantity the authors answer this question by using persistence modeling on weekly sales data of a perishable and a storable product derived from a scanner panel their analysis reveals first that permanent promotion effects are virtually absent for each sales component next the authors develop and apply an impulse response approach to estimate the promotional adjustment period and the total dynamic effects of a price promotion specifically they calculate the long term equivalent of gupta s 1988 14 84 2 breakdown of promotional effects because of positive adjustment effects for incidence but negative adjustment effects for choice the authors find a reversal of the importance of category incidence and brand choice 66 11 23 for the storable product and 58 39 3 for the perishable product the authors discuss the implications of the findings an

market share and the illusion of power can blue cross force hospitals to discount researchers in health care financing have claimed that large private insurers like blue cross frequently exercise monopsony power to obtain discounts from normal hospital charges they claim that the monopsony power derives from a large blue cross share of a given hospital cost shifting whereby hospitals offset the discount by raising charges to less powerful customers this paper re examines both theoretically and empirically the conditions necessary for a private insurer to extract discounts from a hospital we demonstrate that the theoretical conditions necessary for blue cross to force a discount do not exist in the indiana market using revenue data from 110 indiana hospitals we reject the traditional claim that blue cross pays less than other insurers as a function of market share

a control function approach to endogeneity in consumer choice models abstract endogeneity arises for numerous reasons in models of consumer choice it leads to inconsistency with standard estimation methods that maintain independence between the model s error and the included variables the authors describe a control function approach for handling endogeneity in choice models observed variables and economic theory are used to derive controls for the dependence between the endogenous variable and the demand error the theory points to the relationships that contain information on the unobserved demand factor such as the pricing equation and the advertising equation the authors approach is an alternative to berry levinsohn and pakes s 1995 product market controls for unobserved quality the authors apply both methods to examine households choices among television options including basic and premium cable packages in which unobserved attributes such as quality of programming are expected to be correlated with price without correcting for endogeneity aggregate d

designing a tax to discourage unhealthy food and beverage purchases the case of chile the global shift towards diets high in sugar sweetened beverages ssbs and energy dense ultra processed foods is linked to higher prevalence of obesity diabetes and most other noncommunicable diseases ncds causing significant health costs chile has the highest ssb consumption in the world very high junk food intake and very rapid increases in these poor components of the diet plus obesity prevalence this study s purpose is to compare the effect of different tax schemes for ssbs and ultra processed foods on nutrient availability utilizing price elasticities which are estimated from a quadratic almost ideal demand system model using the 2011 2012 income and expenditure survey we take into account the high proportion of households not purchasing various food and beverage groups censored nature of data the food groups considered were sweets and desserts salty snacks and chips meat products and fats fruits vegetables and seafood cereals and cereal products ssb ready to drink ssb from concentrate plain water coffee and tea and milk which together represent 90 of food expenditures the simulated taxes were 1 40 price tax on ssbs 22 above the current tax level 2 a 5 cents per gram of sugar tax on products with added sugar and 3 30 price tax on all foods 27 above current tax levels and beverages 12 above the current tax level exceeding thresholds on sodium saturated fat and added sugar and for which marketing is restricted based on a chilean law effective june 16 2016 unhealthy foods are price elastic 1 99 for salty snacks and chips 1 06 for ssbs ready to drink and 1 27 for ssbs from concentrate meaning that the change in consumption is proportionally larger with respect to a change in price results are robust to different model specification and consistent among different socioeconomic sub populations overall the tax on marketing controlled foods and beverages is associated with the largest reduction in household purchases of sodium added sugar saturated fat and calorie purchases chile is unique in currently having instituted a small current ssb tax as well as marketing controls and front of package labeling of unhealthy foods and beverages the design of a larger more comprehensive tax to enhance the overall effect of these policies on healthier diets is a next critical step this study shows that a large tax on the same foods and beverages already delineated as unhealthy by the marketing controls and front of pack labeling should prove to be more effective for promoting a healthier diet

health insurance as a two part pricing contract monopolies appear throughout health care we show that health insurance operates like a conventional two part pricing contract that allows monopolists to extract profits without inefficiently constraining quantity when insurers are free to offer a range of insurance contracts to different consumer types health insurance markets perfectly eliminate deadweight losses from upstream health care monopolies frictions limiting the sorting of different consumer types into different insurance contracts restore some of these upstream monopoly losses which manifest as higher rates of uninsurance rather than as restrictions in quantity utilized by insured consumers empirical analysis of pharmaceutical patent expiration supports the prediction that heavily insured markets experience little or no efficiency loss under monopoly while less insured markets exhibit behavior more consistent with the standard theory of monopoly

relying on the information of interested parties we investigate the conventional wisdom that competition among interested parties attempting to influence a decisionmaker by providing verifiable information elicits all relevant information we find that if the decisionmaker is strategically sophisticated and well informed about the relevant variables and about the preferences of the interested party or parties competition may be unnecessary to achieve this result if the decisionmaker is unsophisticated or not well informed competition is not generally sufficient if the interested parties interests are sufficiently opposed however or if the decisionmaker is seeking to advance the parties welfare then competition can reduce or even eliminate the decisionmaker s need for prior knowledge about the relevant variables and for strategic sophistication in other settings only the combination of competition among information providers and a sophisticated skepticism is sufficient to allow effective decisionmaking

is hospital competition wasteful stable url http links jstor org sici sici 0741 6261 28199222 2923 3a2 3c247 3aihcw 3e2 0 co 3b2 zthe rand journal of economics is currently published by the rand corporation your use of the jstor archive indicates your acceptance of jstor s terms and conditions of use available athttp www jstor org about terms html jstor s terms and conditions of use provides in part that unless you have obtainedprior permission you may not download an entire issue of a journal or multiple copies of articles and you may use content inthe jstor archive only for your personal non commercial use please contact the publisher regarding any further use of this work publisher contact information may be obtained athttp www jstor org journals rand html each copy of any part of a jstor transmission must contain the same copyright notice that appears on the screen or printedpage of such transmission the jstor archive is a trusted digital repository providing for long term preservation and access to leading academicjournals and scholarly literature from around the world the archive is supported by libraries scholarly societies publishers and foundations it is an initiative of jstor a not for profit organization with a mission to help the scholarly community takeadvantage of advances in technology for more information regarding jstor please contact support jstor org http www jstor orgfri jan 4 14 10 49 2008