SHM Converge Scientific Abstract ePoster Gallery-Hospital Competition

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This study examined whether hospital market competition affects healthcare value, defined as a hospital’s CMS Star Summary Score minus its Medicare Spending per Beneficiary (MSPB) score. The researchers used data from 3,131 hospitals across 186 core-based statistical areas (CBSAs), with market concentration measured by the Herfindahl-Hirschman Index (HHI) from the Health Care Cost Institute.<br /><br />The hypothesis was that reduced competition would lead to lower-value care. However, the results did not support this. Two-thirds of CBSAs were classified as highly or very highly concentrated hospital markets. Surprisingly, hospitals in very highly concentrated markets delivered the highest-value care. In the overall analysis, HHI alone was not significantly associated with hospital value. After adjusting for hospital characteristics, though, each 1,000-point increase in HHI was associated with higher odds of being a high-value hospital (OR 1.24, 95% CI 1.00–1.53, p = 0.045).<br /><br />The findings suggest that, contrary to common concerns, greater hospital market concentration may be linked to better healthcare value rather than worse. This challenges the assumption that more competition automatically improves value. The authors note that while consolidation has often been associated with higher costs, its relationship with quality and value is more complex.

Asset Subtitle

Mahip Grewal

Meta Tag

Author List Caleb Irvine, Huihui Yu, Jeph Herrin, Joshua Ross, Leora Horwitz, Mahip Grewal

Category Research

Concept Hospital Market Competition

Concept Herfindahl-Hirschman Index

Concept Healthcare Value

Concept Hospital Value

Concept CMS Stars

Distinguished Non-Finalist

Presenter Organization NYU Grossman School of Medicine

Presenting Author Mahip Grewal

Track Value in Hospital Medicine

Keywords

hospital market competition

healthcare value

CMS Star Summary Score

Medicare Spending per Beneficiary

Herfindahl-Hirschman Index

market concentration

hospital consolidation

core-based statistical areas

high-value care

healthcare quality

Hospital Market Competition

Herfindahl-Hirschman Index

Healthcare Value

Hospital Value

CMS Stars