Competition in public service provision: The role of not-for-profit  providers

Besley, Timothy; Malcomson, James M.

doi:10.1016/j.jpubeco.2018.04.004

Cited by 21 publications

(5 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Assessments of the impact of such reforms primarily focus on their success of delivering aggregate quality or efficiency improvements that benefit all (Besley & Malcomson, 2018; Bergman et al., 2016; Cooper et al., 2018). However, such reforms are often accompanied by concerns about the way such benefits are distributed across different types of patients.…”

Section: Introductionmentioning

confidence: 99%

Divided by choice? For‐profit providers, patient choice and mechanisms of patient sorting in the English National Health Service

Beckert

Kelly

2021

Health Economics

View full text Add to dashboard Cite

This paper studies patient choice of provider following government reforms in the 2000s, which allowed for‐profit surgical centers to compete with existing public National Health Service (NHS) hospitals in England. For‐profit providers offer significant benefits, notably shorter waiting times. We estimate the extent to which different types of patients benefit from the reforms, and we investigate mechanisms that cause differential benefits. Our counterfactual simulations show that, in terms of the value of access, entry of for‐profit providers benefitted the richest patients twice as much as the poorest, and white patients six times as much as ethnic minority patients. Half of these differences is explained by healthcare geography and patient health, while primary care referral practice plays a lesser, though non‐negligible role. We also show that, with capitated reimbursement, different compositions of patient risks between for‐profit surgical centers and existing public hospitals put public hospitals at a competitive disadvantage.

show abstract

Section: Introductionmentioning

confidence: 99%

Divided by choice? For‐profit providers, patient choice and mechanisms of patient sorting in the English National Health Service

Beckert

Kelly

2021

Health Economics

View full text Add to dashboard Cite

show abstract

“…7 See, e.g. Hart et al (1997), Bajari and Tadelis (2001), Hart (2003), Besley et al (2001), Bajari et al (2014), Besley and Malcomson (2018), Hart (2017), Bennett and Iossa (2006a), Müller and Schmitz (2016), Chen and Chiu (2010), Hoppe and Schmitz (2013) among others.…”

Section: Project Timelinementioning

confidence: 99%

Public–private partnerships vs. traditional contracts for highways

Singh

2018

Ind. Econ. Rev.

View full text Add to dashboard Cite

During the last 2 decades, several countries have used Public-Private Partnerships (PPPs or P3) along with the traditional contracts for development of infrastructure. In this paper, we model the incentive structures induced by PPPs contracts and the traditional procurement contracts used for infrastructure. The model is used to predict outcomes under PPP contracts versus the traditional contracts. Predictions emanating from the model are tested using a data set of 313 national highway projects in India. The empirical analysis examines validity of a widely held belief that PPPs are better than the traditional contracts in terms of the cost and quality of infrastructure. We show that the construction costs are significantly higher for PPPs than the traditionally procured (non-PPP) highways. Besides, we compare the quality of PPPs with the non-PPP roads. Our analysis shows that the PPPs encourage life-cycle approach towards project costs. This effect is more pronounced for Toll-PPPs than for Non-toll-PPPs. Moreover, the quality of PPP roads is better than the traditional highways.

show abstract

“…A large body of theoretical literature suggests that for‐profits and non‐profits have different objectives (an example which focuses on public service providers is Besley & Malcomson, 2018). Early empirical studies provided mixed evidence for quality differences between for‐profit and other hospitals 2 .…”

Section: Introductionmentioning

confidence: 99%

Assessing the quality of public services: For‐profits, chains, and concentration in the hospital market

Kunz,

Propper,

Staub

et al. 2024

Health Economics

View full text Add to dashboard Cite

We examine variation in US hospital quality across ownership, chain membership, and market concentration. We propose a new measure of quality derived from penalties imposed on hospitals under the flagship Hospital Readmissions Reduction Program, and use regression models to risk‐adjust for hospital characteristics and county demographics. While the overall association between for‐profit ownership and quality is negative, there is evidence of substantial heterogeneity. The quality of for‐profit relative to non‐profit hospitals declines with increasing market concentration. Moreover, the quality gap is primarily driven by for‐profit chains. While the competition result mirrors earlier findings in the literature, the chain result appears to be new: it suggests that any potential quality gains afforded by chains are mostly realized by not‐for‐profit hospitals.

show abstract

Competition in public service provision: The role of not-for-profit providers

Cited by 21 publications

References 43 publications

Divided by choice? For‐profit providers, patient choice and mechanisms of patient sorting in the English National Health Service

Divided by choice? For‐profit providers, patient choice and mechanisms of patient sorting in the English National Health Service

Public–private partnerships vs. traditional contracts for highways

Assessing the quality of public services: For‐profits, chains, and concentration in the hospital market

Contact Info

Product

Resources

About