The Impact of Organizational Boundaries on Healthcare Coordination and Utilization
Keith Marzilli Ericson
- American Economic Journal: Economic Policy (Forthcoming)
We measure organizational concentration—the distribution of a patient's healthcare
across organizations—to examine how firm boundaries affct healthcare efficiency.
First, when patients move to regions where outpatient visits are typically concentrated
within a small set of firms, their healthcare utilization falls. Second, for patients whose
PCPs exit the market, switching to a PCP with 1 standard deviation higher organizational concentration reduces utilization by 21%. This finding is robust to controlling
for the spread of healthcare across providers. Increases in organizational concentration predict improvements in diabetes care and are not associated with greater use of
emergency department or inpatient care.
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