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Health Care Price Competition

Report
Health Care Consolidation: What Does the Evidence Say?
Hospital horizontal consolidation is associated with higher prices paid to providers. And there is some evidence of the same for vertical consolidation of hospitals and physician practices. What effect might the No Surprises Act—created to protect consumers from surprise medical bills—have on consolidation trends?
Sep 30, 2022
Journal Article
Higher Medicare Spending On Imaging And Lab Services After Primary Care Physician Group Vertical Integration
This study highlights how the growing trend of vertical integration, combined with differences in Medicare payment between hospitals and nonhospital providers, leads to higher Medicare spending.
Sep 20, 2022
Report
Increasing Price Transparency in Health Care: Key Themes and Policy Options from a Technical Expert Panel
RAND researchers examine current price transparency efforts and their features, describe barriers to more widespread availability and use of price information, and discuss possible ways to overcome those barriers.
Feb 16, 2021
Blog
Youth Sports, Autonomous Vehicles, Mental Health: RAND Weekly Recap
This weekly recap focuses on why low-income children aren't playing sports, who's liable when autonomous vehicles get hacked, supporting children with mental health issues, and more.
Jul 19, 2019
Commentary
Price-Fixing Case Reveals Vulnerability of Generic Drug Policies
A massive lawsuit filed by 44 states accuses 20 major drug makers of colluding to inflate prices on more than 100 generic drugs, including HIV, cancer, and depression treatments. If these allegations are true, then this isn't just a violation of antitrust law. It's a betrayal of the policies that created and defended the entire generic drug industry.
Jul 15, 2019
Commentary
Addressing Surprise Medical Bills Without Raising the Cost of Health Care
Patients who try to stay within their insurers' networks can be hit with surprise bills when they unknowingly receive care from out-of-network physicians. How much should a physician be paid for providing a service that is critical but rendered without the patient's ready ability to choose an in-network provider?
Apr 1, 2019
Journal Article
Encouraging Patient Price Shopping: Which Methods Work?
Efforts to encourage patient price shopping through access to price transparency tools have met with limited success. However, combining these tools with reference pricing simplifies decisionmaking by steering patients to low-priced providers and giving them a financial incentive to comply with the nudge.
Aug 2, 2018
Journal Article
Offering A Price Transparency Tool Did Not Reduce Overall Spending Among California Public Employees And Retirees
California public employees and retirees who were offered a price transparency tool did not spend less on a set of "shoppable" health care services than others who were not offered the tool.
Aug 29, 2017
Commentary
Bringing Sky-High Prescription Drug Prices Down to Earth
Increased competition among drug companies and improved bargaining power of insurers and consumers could help keep high prescription prices in check.
Dec 10, 2015
Report
International Price Comparison for Pharmaceuticals
The international impact of pharmaceutical pricing changes in the United Kingdom is likely to be minimal or indirect. This is due largely to the diverse ways that various other countries implement international price comparisons.
Jun 4, 2013
Journal Article
Impact of Socioeconomic Adjustment on Physicians' Relative Cost of Care
Ongoing efforts to profile physicians on their relative cost of care have been criticized because they do not account for differences in patients' socioeconomic status (SES).
Apr 26, 2013
Commentary
Provider Consolidation Key Factor in Affordable Coverage
Hospitals operating with little competition are able to charge health plans much higher prices, which are passed on to consumers in the form of higher insurance premiums, writes Glenn Melnick.
Nov 28, 2011
Journal Article
Consolidation of Health Plans May Help Lower Hospital Costs
Increased consolidation among health plans nationally may benefit consumers by lowering hospital prices, at least in those regions where health plans are the most consolidated.
Sep 1, 2011
Journal Article
Competition and the Mental Health System
This article describes three notable features of the competitive mental health care market and their policy implications.
Jan 1, 2009
Journal Article
Nonprice Competition and Quality of Care in Managed Care: The New York SCHIP Market
Finds a negative association between nonprice competition and quality of care in managed care plans in the New York SCHIP market. Pricing policy is likely a constraint on quality production, though it may not be interpreted as a causal relationship.
Jun 1, 2008
Journal Article
Organizational Culture and Physician Satisfaction with Dimensions of Group Practice
Male physicians were less satisfied with data capabilities. Primary care physicians (versus specialists) were less satisfied with price competition.
Jan 1, 2007
Journal Article
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)
Jan 1, 2003
Journal Article
Can Cost Shifting Continue in a Price Competitive Environment?
Both Medicare and Medicaid are reducing payments to hospitals, and there is widespread concern that hospitals may respond by increasing prices to privately insured patients.
Jan 1, 2000
Journal Article
Price Competition and Hospital Cost Growth in the United States (1989-1994)
In relative terms, the authors estimate that HMOs have contained cost growth more effectively than PPOs.
Jan 1, 1999
Report
State health care expenditures under competition and regulation, 1980 through 1991
State health care expenditures under competition and regulation, 1980 through 1991
Jan 1, 1996

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Researcher Spotlight

Cheryl L. Damberg

Director, RAND Center of Excellence on Health System Performance

Cheryl Damberg is director of the RAND Center of Excellence on Health System Performance, distinguished chair in Health Care Payment Policy, and a principal senior economist at the RAND Corporation. Her research explores the impact of strategies to drive cost and quality improvements in health…
Brenna O'Neill

Research Programmer

Brenna O'Neill (she/her) is a research programmer in the RAND Corporation's Research Programming Group. She works primarily in RAND Healthcare, and performs database management as well as analytic tasks including extracting, cleaning and maintaining large complex datasets, as well as performing…

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