Annotated Bibliography 3
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Annotated Bibliography 3
Brielle West
Arnold, Daniel. “Who Pays for Health Care Costs?: The Effects of Health Care Prices on Wages,” July 28, 2020. https://www.rand.org/pubs/working_papers/WRA621-2.html
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For many health insurance is supplied through their employment, however as health care costs have continued to rise over the recent years, concerns have been raised that healthcare spending uproots wage increases. Daniel Arnold’s “Who Pays for Health Care Costs?: The Effects of Health Care Prices on Wages” aims to test the impact of health care prices on wages and medical benefits that are awarded. Using data sources from the American Community Survey (ACS), Health Care Cost Institute (HCCI), and Hospital Cost Report Information Service (HCRIS), the author measured how the changing healthcare market structures and framework have led to changes in both wages and healthcare costs. What was found was that over the period of 2010 to 2016, hospital mergers led to a 2.6% in hospital prices and a $579 increase in hospital spending. Looking at the period from 2010 to 2018 it was found that there was a $637 or roughly a %1.0 decrease in wages. What the mergers indicate and studies have found as the paper points out is that one way in which employers respond to the rising healthcare costs is by reducing wages. This paper concludes that Americans feel the effects of the rising healthcare costs on two fronts: through higher prices and slower wage growth. Glied, Sherry, Sara R. Collins, and Saunders Lin. “Did the ACA Lower Americans’ Financial Barriers To Health Care?” Health Affairs 39, no. 3 (March 1, 2020): 379-86. https://doi.org/10.1377/h1thaff.2019.01448
The Affordable Care Act (ACA) which was implemented in 2010 was designed to provide financial protection to Americans when they use the healthcare system. However,
in order for that to happen the ACA had to address two problems: the cost barriers to
accessing care and coverage, and the barriers to comprehensive risk protection provided by insurance. “Did the ACA Lower Americans’ Financial Barriers To Health Care?” by Sherry Glied, Sara Collins, and Saunders Lin examine ACA provisions such as Medicaid expansion and health insurance marketplaces to determine if the laws that have been put in place were effective in achieving its goals of making it easier for individuals to access healthcare services in the U.S. The beginning of article begins by looking at the new laws
that were put in place as well as the implementation of two new federally subsidized insurance expansions. While the ACA did achieve in expanding coverage for millions of Americans; by reducing the financial barriers to coverage and improving access to healthcare, the article also acknowledges the challenges that arise such as rising premiums and gaps in medical coverage. Gudiksen, Katherin L. “Who Can Rein in Health Care Prices? State and Federal Efforts to Address Health Care Provider Consolidation,” June 24, 2021. https://researchspace.auckland.ac.nz/handle/2292/56429
“Who Can Rein in Health Care Prices? State and Federal Efforts to Address Health Care Provider Consolidation” by Katherine Gudiksen, Alexandra Montague, and Jaime King looks at the actions state and federal governments have taken to address the downsides that have occurred because of the consolidation of healthcare providers. During the height of the COVID-19 pandemic, it was reported that one in five adults skipped necessary medical care because of costs, that is roughly 46 million people. One reason for
the increase in healthcare prices is that healthcare providers have been consolidating into healthy systems that hold substantial market power, which has driven up prices, through the form of being able to leverage price negotiations with insurance companies. The report goes on to say that there needs to be continued state actions to protect individuals
against the negatives of healthcare consolidation. A way in which the authors suggest that
could demonstrate the impact of health care consolidation is to make prices more publicly
available, for there to be more transparency. However, the authors realize that price transparency alone will not constrain healthcare price increases and that state policymakers may need help from the federal government. Reed, Brent S. “The Impact of Hospital Consolidations: Who Is Really Benefiting from M&A’s within Healthcare?” ScholarWorks@GVSU, n.d. https://scholarworks.gvsu.edu/spnhareview/vol16/iss1/8
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This paper written by Brent Reed entitled “The Impact of Hospital Consolidations: Who Is Really Benefiting from M&A’s within Healthcare?” seeks to define what the impact is on patients and health systems as a result of large mergers and acquisitions. The first half of the paper serves as a foundation of knowledge in antitrust laws, what led to such laws, and how the laws are effectively enforced. It touches on the three core laws that make up antitrust legislation: the Sherman Act, the Clayton Act, and the Federal Trade Commission Act. The second half of the paper is a literature review that provides evidence of how hospital consolidations have bypassed antitrust laws and consequently have had a negative impact on healthcare costs and patient outcomes. What the paper concludes upon is that the impact of major mergers and acquisitions of hospitals results in
patients paying more, lower quality of care is received, and there is no way yet of knowing if these mergers actually improve financial stability. The research that has been done so far all points that the FTC and the DOJ need to continue investigating M&A’s in healthcare and that policymakers at both the state and federal levels should question the reported benefits of consolidated healthcare systems.
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Zhang, Jonathan, Yiwei Chen, Liran Einav, Jonathan Levin, and Jay Bhattacharya. “Consolidation of Primary Care Physicians and Its Impact on Healthcare Utilization.” Health Economics
30, no. 6 (March 25, 2021): 1361-73. https://doi.org/10.1002/hec.4257
In the article written by Jonathan Zhang, “Consolidation of Primary Care Physicians and Its Impact on Healthcare Utilization” Zhang offers many insights into primary care physicians’ consolidation. The paper looked at the effect of consolidation on total patient utilization. The research used administrative data from Medicare from 2008 to 2014 to document the consolidation of primary physicians over the last decade and how this consolidation has impacted healthcare. Medicare data was used because prices are regulated, so overall spending is driven by healthcare utilization. This allowed researchers to ignore the impact on prices and market power and focus on the impact of primary care consolidations and their impact on patient utilization. The research found that consolidation resulted in increased access to care because of enhanced resources and improved care coordination. However, the research also highlighted the possible and potential downsides of physician consolidation. One of those downsides was the reduced competition which could lead to higher healthcare costs. What is suggested for future consolidation is there needs to be a well-balanced approach to consolidation, one that both maximizes the benefits but also limits potential drawbacks. Summary
For the third installment of annotated bibliographies, the majority of the articles focus on the impacts of the consolidation of hospital and healthcare systems. The consensus that can be found between the three articles that focus on hospital and health system consolidation is that while it increased access to healthcare it also resulted in healthcare prices continuing to rise. One
reason that is cited for this is that through consolidation, healthcare systems are able to hold
substantial market power. While one of the articles touches upon the effects of consolidation, its primary focus is what effect the increase in healthcare prices has had on wage growth, and also looks at how employers and companies react to rising healthcare costs. The final article assess the impacts of the ACA.