The Impact of Vertical Integration on Physician Behavior and Healthcare Delivery: Evidence from Gastroenterology Practices

References

• Adams MA, Prenovost KM, Dominitz JA, Holleman RG, Kerr EA, Krein SL, Saini SD, Rubenstein JH (2017) Predictors of use of monitored anesthesia care for outpatient gastrointestinal endoscopy in a capitated payment system. Gastroenterology 153(6):1496–1503.Crossref, Google Scholar
• Allen JI, Kaushal N (2018) New models of gastroenterology practice. Clin. Gastroenterology Hepatology 16(1):3–6.Crossref, Google Scholar
• Arifoğlu K, Ren H, Tezcan T (2020) Hospital Readmissions Reduction Program does not provide the right incentives: Issues and remedies. Management Sci. 67(4):2191–2210.Link, Google Scholar
• Atkinson M, Saghafian S (2023) Who should see the patient? On deviations from preferred patient-provider assignments in hospitals. Health Care Management Sci. 26:165–199.Google Scholar
• Baicker K, Levy H (2013) Coordination vs. competition in healthcare reform. New England J. Medicine 369(9):789–791.Crossref, Google Scholar
• Baker LC, Bundorf MK, Kessler DP (2014) Vertical integration: Hospital ownership of physician practices is associated with higher prices and spending. Health Affairs 33(5):756–763.Crossref, Google Scholar
• Baker LC, Bundorf MK, Devlin AM, Kessler DP (2018) Hospital ownership of physicians: Hospital vs. physician perspectives. Medical Care Res. Rev. 75(1):88–99.Crossref, Google Scholar
• Barnett ML, Keating NL, Christakis NA, O’Malley AJ, Landon BE (2012) Reasons for choice of referral physician among primary care and specialist physicians. J. General Internal Medicine 27(5):506–512.Crossref, Google Scholar
• Benjamini Y, Hochberg Y (1995) Controlling the false discovery rate: A practical and powerful approach to multiple testing. J. Roy. Statist. Soc. Ser. A 57(1):289–300.Google Scholar
• Bertram MY, Lauer JA, De Joncheere K, Edejer T, Hutubessy R, Kieny MP, Hill SR (2016) Cost-effectiveness thresholds: Pros and cons. Bull. World Health Organ. 94(12):925–930.Crossref, Google Scholar
• Boloori A, Saghafian S, Chakkera HA, Cook CB (2020) Data-driven management of post-transplant medications: An ambiguous partially observable Markov decision process approach. Manufacturing Service Oper. Management 22(5):1066–1087.Link, Google Scholar
• Burns LR, Goldsmith JC, Sen A (2013) Horizontal and vertical integration of physicians: A tale of two tails. Adv. Health Care Management 15:39–117.Crossref, Google Scholar
• Capps C, Dranove D, Ody C (2017) Physician practice consolidation driven by small acquisitions, so antitrust agencies have few tools to intervene. Health Affairs 36(9):1556–1563.Crossref, Google Scholar
• Capps C, Dranove D, Ody C (2018) The effect of hospital acquisitions of physician practices on prices and spending. J. Health Econom. 59:139–152.Crossref, Google Scholar
• Carlin CS, Dowd B, Feldman R (2015) Changes in quality of healthcare delivery after vertical integration. Health Services Res. 50(4):1043–1068.Crossref, Google Scholar
• Centers for Medicare & Medicaid Services (2016) Medicare provider utilization and payment data: Physician and other supplier.Google Scholar
• Chan CW, Farias VF, Escobar GJ (2016) The impact of delays on service times in the intensive care unit. Management Sci. 63(7):2049–2072.Link, Google Scholar
• Chan CW, Green LV, Lekwijit S, Lu L, Escobar G (2019) Assessing the impact of service level when customer needs are uncertain: An empirical investigation of hospital step-down units. Management Sci. 65(2):751–775.Link, Google Scholar
• Chen C, Savva N (2018) Unintended consequences of hospital regulation: The case of the Hospital Readmissions Reduction Program. Working paper.Google Scholar
• Chen S, Rex D (2004) Registered nurse-administered propofol sedation for endoscopy. Alimentary Pharmacology Therapeutics 19(2):147–155.Crossref, Google Scholar
• Chronic Condition Data Warehouse (2014) Chronic condition data warehouse.Google Scholar
• Clough JD, Dinan MA, Schulman KA (2017) Trends in hospital-physician integration in medical oncology. Amer. J. Managed Care 23(10):624–627.Google Scholar
• Cooper GS, Xu F, Barnholtz Sloan JS, Schluchter MD, Koroukian SM (2012) Prevalence and predictors of interval colorectal cancers in Medicare beneficiaries. Cancer 118(12):3044–3052.Crossref, Google Scholar
• Corley DA, Jensen CD, Marks AR, Zhao WK, Lee JK, Doubeni CA, Zauber AG, et al. (2014) Adenoma detection rate and risk of colorectal cancer and death. New England J. Medicine 370(14):1298–1306.Crossref, Google Scholar
• Cuellar AE, Gertler PJ (2006) Strategic integration of hospitals and physicians. J. Health Econom. 25(1):1–28.Crossref, Google Scholar
• Desai S, McWilliams JM (2018) Consequences of the 340B drug pricing program. New England J. Medicine 378(6):539–548.Crossref, Google Scholar
• Elixhauser A, Steiner C, Harris DR, Coffey RM (1998) Comorbidity measures for use with administrative data. Medical Care 36(1):8–27.Crossref, Google Scholar
• Forlines GL (2017) Trends and drivers of physician-hospital integration: The role of Medicare reimbursement. Working paper, Research Triangle Institute, Research Triangle Park, NC.Google Scholar
• Gaynor M (2014) Competition policy in healthcare markets: Navigating the enforcement and policy maze. Health Affairs 33(6):1088–1093.Crossref, Google Scholar
• Gaynor M, Moreno-Serra R, Propper C (2013) Death by market power: Reform, competition, and patient outcomes in the National Health Service. Amer. Econom. J. Econom. Policy 5(4):134–166.Crossref, Google Scholar
• Gillies RR, Shortell SM, Anderson DA, Mitchell JB, Morgan KL (1993) Conceptualizing and measuring integration: Findings from the health systems integration study. Hospital Health Services Admin. 38(4):467–489.Google Scholar
• Gohel TD, Burke CA, Lankaala P, Podugu A, Kiran RP, Thota PN, Lopez R, Sanaka MR (2014) Polypectomy rate: A surrogate for adenoma detection rate varies by colon segment, gender, and endoscopist. Clinical Gastroenterology Hepatology 12(7):1137–1142.Crossref, Google Scholar
• Graves N, Halton K, Lairson D (2007) Economics and preventing hospital-acquired infection: Broadening the perspective. Infection Control Hospital Epidemiology 28(2):178–184.Crossref, Google Scholar
• Heese HS (2007) Inventory record inaccuracy, double marginalization, and RFID adoption. Production Oper. Management 16(5):542–553.Crossref, Google Scholar
• Johnson CM, Wei C, Ensor JE, Smolenski DJ, Amos CI, Levin B, Berry DA (2013) Meta-analyses of colorectal cancer risk factors. Cancer Causes Control 24(6):1207–1222.Crossref, Google Scholar
• Kaminski MF, Regula J, Kraszewska E, Polkowski M, Wojciechowska U, Didkowska J, Zwierko M, Rupinski M, Nowacki MP, Butruk E (2010) Quality indicators for colonoscopy and the risk of interval cancer. New England J. Medicine 362(19):1795–1803.Crossref, Google Scholar
• KC DS, Terwiesch C (2009) Impact of workload on service time and patient safety: An econometric analysis of hospital operations. Management Sci. 55(9):1486–1498.Link, Google Scholar
• Khiani VS, Soulos P, Gancayco J, Gross CP (2012) Anesthesiologist involvement in screening colonoscopy: Temporal trends and cost implications in the Medicare population. Clinical Gastroenterology Hepatology 10(1):58–64.Crossref, Google Scholar
• Koch TG, Wendling BW, Wilson NE (2017) How vertical integration affects the quantity and cost of care for Medicare beneficiaries. J. Health Econom. 52:19–32.Crossref, Google Scholar
• Kocher R, Sahni NR (2011) Hospitals’ race to employ physicians—The logic behind a money-losing proposition. New England J. Medicine 364(19):1790–1793.Crossref, Google Scholar
• Konetzka RT, Stuart EA, Werner RM (2018) The effect of integration of hospitals and post-acute care providers on Medicare payment and patient outcomes. J. Health Econom. 61:244–258.Crossref, Google Scholar
• Li X, Li Y, Cai X (2013) Double marginalization and coordination in the supply chain with uncertain supply. Eur. J. Oper. Res. 226(2):228–236.Crossref, Google Scholar
• Madison K (2004) Hospital-physician affiliations and patient treatments, expenditures, and outcomes. Health Services Res. 39(2):257–278.Crossref, Google Scholar
• McGuire TG (2000) Physician agency. Culyer AJ, Newhouse JP, eds. Handbook of Health Economics, vol. 1 (Elsevier, Amsterdam), 461–536.Google Scholar
• Medicare Payment Advisory Commission (United States) (2017) Report to the Congress, Medicare Payment Policy, Medicare Payment Advisory Commission, Washington, DC.Google Scholar
• Meng L, Batt R, Terwiesch C (2021) The impact of facility layout on service worker behavior: An empirical study of nurses in the emergency department. Manufacturing Service Oper. Management 23(4):819–834.Link, Google Scholar
• Neprash HT, Chernew ME, Hicks AL, Gibson T, McWilliams JM (2015) Association of financial integration between physicians and hospitals with commercial healthcare prices. JAMA Internal Medicine 175(12):1932–1939.Crossref, Google Scholar
• Nikpay SS, Richards MR, Penson D (2018) Hospital-physician consolidation accelerated in the past decade in cardiology, oncology. Health Affairs 37(7):1123–1127.Crossref, Google Scholar
• Office of Inspector General (2014) Medicare and beneficiaries could save billions if CMS reduces hospital outpatient department payment rates for ambulatory surgical center-approved procedures to ambulatory surgical center payment rates. Department of Health and Human Services Audit Report A-05-12-00020. Washington, DC.Google Scholar
• Pace D, Borgaonkar M (2018) Deep sedation for colonoscopy is unnecessary and wasteful. CMAJ 190(6):E153–E154.Crossref, Google Scholar
• Pandya A, Soeteman DI, Gupta A, Kamel H, Mushlin AI, Rosenthal MB (2020) Can pay-for performance incentive levels be determined using a cost-effectiveness framework? Circulation: Cardiovascular Quality Outcomes 13(7):e006492.Crossref, Google Scholar
• Patel NC, Islam RS, Wu Q, Gurudu SR, Ramirez FC, Crowell MD, Faigel DO (2013) Measurement of polypectomy rate by using administrative claims data with validation against the adenoma detection rate. Gastrointestinal Endoscopy 77(3):390–394.Crossref, Google Scholar
• Post B, Buchmueller T, Ryan AM (2018) Vertical integration of hospitals and physicians: Economic theory and empirical evidence on spending and quality. Medical Care Res. Rev. 75(4):399–433.Crossref, Google Scholar
• Quantin C, Benzenine E, Hägi M, Auverlot B, Abrahamowicz M, Cottenet J, Fournier E, et al. (2012) Estimation of national colorectal cancer incidence using claims databases. J. Cancer Epidemiology 2012:298369.Crossref, Google Scholar
• Rabeneck L, Paszat LF, Hilsden RJ, Saskin R, Leddin D, Grunfeld E, Wai E, Goldwasser M, Sutradhar R, Stukel TA (2008) Bleeding and perforation after outpatient colonoscopy and their risk factors in usual clinical practice. Gastroenterology 135(6):1899–1906.Crossref, Google Scholar
• Rex DK, Petrini JL, Baron TH, Chak A, Cohen J, Deal SE, Hoffman B, et al. (2006) Quality indicators for colonoscopy. Amer. J. Gastroenterology 101(4):73–90.Crossref, Google Scholar
• Robinson JC, Brown TT, Whaley C, Finlayson E (2015) Association of reference payment for colonoscopy with consumer choices, insurer spending, and procedural complications. JAMA Internal Medicine 175(11):1783–1789.Crossref, Google Scholar
• Roth J, Sant’Anna PH, Bilinski A, Poe J (2023) What’s trending in difference-in-differences? A synthesis of the recent econometrics literature. J. Econometrics 235(2):2218–2244.Google Scholar
• Saghafian S, Hopp WJ (2019) The role of quality transparency in healthcare: Challenges and potential solutions. NAM Perspectives. Commentary, National Academy of Medicine, Washington, DC.Google Scholar
• Saghafian S, Hopp WJ (2020) Can public reporting cure healthcare? The role of quality transparency in improving patient-provider alignment. Oper. Res. 68(1):71–92.Link, Google Scholar
• Saghafian S, Kilinc D, Traub SJ (2023) Dynamic assignment of patients to primary and secondary inpatient units: Is patience a virtue? Cambridge Handbook on Productivity, Efficiency and Effectiveness in Healthcare. Forthcoming.Google Scholar
• Saghafian S, Song L, Raja A (2022) Toward a more efficient healthcare system: Opportunities and challenges caused by hospital closures amid the COVID-19 pandemic. Health Care Management Sci. 25:187–190.Crossref, Google Scholar
• Saghafian S, Hopp WJ, Iravani SMR, Cheng Y, Diermeier D (2018) Workload management in telemedical physician triage and other knowledge-based service systems. Management Sci. 64(11):5180–5197.Google Scholar
• Scott KW, Orav EJ, Cutler DM, Jha AK (2017) Changes in hospital-physician affiliations in US hospitals and their effect on quality of care. Ann. Internal Medicine 166(1):1–8.Crossref, Google Scholar
• Singer SJ, Kerrissey M, Friedberg M, Phillips R (2020) A comprehensive theory of integration. Medical Care Res. Rev. 77(2):196–207.Crossref, Google Scholar
• Singh H, Poluha W, Cheang M, Choptain N, Inegbu E, Baron K, Taback SP (2008) Propofol for sedation during colonoscopy. Cochrane Database Systematic Rev. 2008(4):CD006268.Google Scholar
• Song LD, Saghafian S (2019) The spillover effects of hospital closures on the efficiency and quality of other hospitals. HKS Working Paper No. RWP19-006, Harvard University, Cambridge, MA.Google Scholar
• Song Y, Skinner J, Bynum J, Sutherland J, Wennberg JE, Fisher ES (2010) Regional variations in diagnostic practices. New England J. Medicine 363(1):45–53.Crossref, Google Scholar
• Staats BR, Dai H, Hofmann D, Milkman KL (2017) Motivating process compliance through individual electronic monitoring: An empirical examination of hand hygiene in healthcare. Management Sci. 63(5):1563–1585.Link, Google Scholar
• Sun L, Shapiro JM (2022) A linear panel model with heterogeneous coefficients and variation in exposure. J. Econom. Perspect. 36(4):193–204.Google Scholar
• Tan TF, Netessine S (2019) When you work with a superman, will you also fly? An empirical study of the impact of coworkers on performance. Management Sci. 65(8):3495–3517.Link, Google Scholar
• Tingley D, Yamamoto T, Hirose K, Keele L, Imai K (2014) Mediation: R package for causal mediation analysis. J. Statist. Software 59(5):1–38.Crossref, Google Scholar
• U.S. Government Accountability Office (2015) Increasing hospital-physician consolidation highlights need for payment reform. Report to Congressional Requesters GAO-16-189.Google Scholar
• U.S. Preventive Services Task Force (2008) Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. Ann. Internal Medicine 149(9):627.Crossref, Google Scholar
• van der Wal WM, Geskus RB (2011) ipw: An R package for inverse probability weighting. J. Statist. Software 43(13):1–23.Google Scholar
• Vlachy J, Ayer T, Ayvaci M, Raghunathan S (2017) The business of healthcare: Physician integration in bundled payments. Working paper, Georgia Institute of Technology, Atlanta.Google Scholar
• Wagner AR (2016) Effect of physician-hospital financial integration on health outcomes and spending. Working paper, University of West Georgia, Carrollton, GA.Google Scholar
• Wang J, Zhou YP (2018) Impact of queue configuration on service time: Evidence from a supermarket. Management Sci. 64(7):3055–3075.Link, Google Scholar
• Warren JL, Klabunde CN, Mariotto AB, Meekins A, Topor M, Brown ML, Ransohoff DF (2009) Adverse events after outpatient colonoscopy in the Medicare population. Ann. Internal Medicine 150(12):849–857.Crossref, Google Scholar
• Winawer SJ, Zauber AG, Fletcher RH, Stillman JS, O’brien MJ, Levin B, Smith RA, et al. (2006) Guidelines for colonoscopy surveillance after polypectomy: A consensus update by the U.S. multi-society task force on colorectal cancer and the American Cancer Society. CA Cancer J. Clinicians 56(3):143–159.Crossref, Google Scholar