The researchers estimated the impact of physician concentration, physician-hospital integration, and accountable care organizations (ACOs) on prices paid for physician services. They used Truven MarketScan claims data from large employers to construct price indices at the market level for a representative set of physician services. They also used American Medical Association (AMA) Group Practice (GP) data linked to Medicare claims via national provider identifiers to measure market share of provider groups, a claims-based metric to measure physician-hospital integration, ACO provider networks and linked claims to measure ACO penetration and American Hospital Association (AHA) data to examine hospital market concentration. The goal of this project was to inform regulatory policy discussions of provider concentration and integration.
This project was funded as part of the Foundation’s solicitation “Understanding the Use and Impact of Price Data in Health Care,” which supports empirical research studies that contribute to the knowledge base in this area, with the goal of providing reliable and generalizable evidence to inform policymakers and delivery system participants and to help accelerate progress toward using price information effectively.