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Do HMOs have monopsony power?

R Feldman1, D Wholey

  • 1Division of Health Services Research and Policy, University of Minnesota, 420 Delaware St, SE, Box 729, Minneapolis, MN 55455, USA. feldm002@tc.umn.edu

International Journal of Health Care Finance and Economics
|November 25, 2003
PubMed
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Health maintenance organizations (HMOs) do not appear to possess monopsony power in hospital markets. Their buying power influences hospital prices and utilization, but not ambulatory care markets.

Area of Science:

  • Health Economics
  • Market Analysis
  • Healthcare Policy

Background:

  • Health Maintenance Organizations (HMOs) are significant purchasers of healthcare services.
  • Understanding market power dynamics is crucial for healthcare pricing and access.
  • Previous research has explored the impact of managed care on healthcare markets.

Purpose of the Study:

  • To investigate whether Health Maintenance Organizations (HMOs) exhibit monopsony power in ambulatory care and inpatient hospital service markets.
  • To analyze the relationship between HMO market share and healthcare prices/utilization.

Main Methods:

  • Utilized a pooled time-series analysis of US HMO data from 1985-1997.
  • Linked InterStudy data with state regulatory financial data and Area Resource File characteristics.

Related Experiment Videos

  • Employed a two-stage regression design to assess HMO buying power's effect on prices and utilization.

    • Main Results:

    • Increased HMO buying power correlated with reduced prices and increased utilization for inpatient hospital services.
    • No significant relationship was found between HMO buying power and ambulatory visit prices or utilization per member.

    Conclusions:

    • Findings do not support the monopsony hypothesis for HMOs in hospital markets.
    • HMOs may have facilitated a welfare-enhancing reduction in hospital monopoly power.
    • The impact of HMO buying power on ambulatory care markets is complex and requires further investigation.