Forum Session

Strong Providers, Big Prices: A Look at Provider Market Power in Health Care
February 12, 2016


Sally Coberly, PhD


Health care providers who have clout due to their size, reputation, location, or other factors, are able to wield market power and charge higher prices for their services than their competitors. The result? Higher health care costs overall, with no guarantee of higher quality. Although anti-trust enforcement at both state and federal levels has been more vigorous and successful in recent years, its utility as a tool to promote competition is limited in markets that are already highly concentrated or dominated by "must have" providers. Many states have begun implementing other activities and policies to promote greater price competition. These efforts range from requiring price transparency for certain services to imposing all-payer rate setting. The success of these strategies has been mixed. This Forum session looked at the effects of market power on health care prices and discussed strategies to promote more competitive markets in health care.


Robert Berenson, MD (bio)
Institute Fellow
Urban Institute

Karen C. Tseng, JD (bio)
Chief, Health Care Division
Office of the Attorney General
Commonwealth of Massachusetts

Paul Ginsburg, PhD (bio)
Norman Topping Chair in Medicine and Public Policy
Sol Price School of Public Policy
Director of Health Policy
Schaeffer Center for Health Policy and Economics
University of Southern California

Helen Darling, MA (bio)
Strategic Advisor in Health Benefits and Policy
Former President and Chief Executive Officer

National Business Group on Health>

Related Materials

National Academy of Social Insurance, "Addressing Pricing Power in Health Care Markets: Principles and Policy Options to Strengthen and Shape Markets" (April 2015).

Massachusetts Attorney General's Office's market examinations: reports from 2010, 2011, 2013, and 2015.

Zack Cooper et al., "The Price Ain't Right? Hospital Prices and Health Spending on the Privately Insured" (National Bureau of Economic Research Working Paper No. 21815, December 2015).

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