Insurer‐hospital bargaining: negotiated discounts in post‐deregulation connecticut

Abstract

This paper uses unique data from the state of Connecticut to examine discounting patterns in the state's hospital industry for the years following deregulation (1995‐1998). The data provide a rare opportunity to study payer‐level differences in negotiated discounts for hospital services. In addition to presenting descriptive evidence on how discounts vary across payers, payer types and hospital types, this study uses matched revenue data to analyze and empirically estimate the economic determinants of discount magnitudes. Payer size appears to affect bargaining power, but the economic significance of the effect is small. Much larger than the effect of payer size is the influence of payers' abilities to ‘move market share’ by channeling patients to hospitals with which favorable discounts have been negotiated.

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