ArticleHealth economics, policy, and law2020
Does managed competition constrain hospitals' contract prices? Evidence from the Netherlands.
Article in Health economics, policy, and law, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed, 29 citations in OpenAlex.
- Market strategies used by private hospital providers to consolidate and increase power; a systematic scoping review and evaluative synthesis.Globalization and health · 2026Article
- Price transparency in the Dutch market-based health care system: did price dispersion for similar hospital services reduce over time?The European journal of health economics : HEPAC : health economics in prevention and care · 2025Article
- Does hospital competition improve the quality of outpatient care? - empirical evidence from a quasi-experiment in a Chinese city.Health economics review · 2024Article
- Healthcare price transparency in North America and Europe.The British journal of radiology · 2023Review
- Reimbursement of care does not equal the distribution of hospital resources: an explorative case study on a missing link among Dutch hospitals.BMC health services research · 2023Article
- Does competition improve hospital performance: a DEA based evaluation from the Netherlands.The European journal of health economics : HEPAC : health economics in prevention and care · 2023Article
- Improving Performance in Complex Surroundings: A Mixed Methods Evaluation of Two Hospital Strategies in the Netherlands.International journal of health policy and management · 2023Article
- Have Dutch Hospitals Saved Lives and Reduced Costs? A longitudinal patient-level analysis over the years 2013-2017.Health economics · 2021Article
- Prices and market power in mental health care: Evidence from a major policy change in the Netherlands.Health economics · 2021Article
- Confronting power in low places: historical analysis of medical dominance and role-boundary negotiation between health professions in Nigeria.BMJ global health · 2020Review
- Power and Purchasing: Why Strategic Purchasing Fails.The Milbank quarterly · 2020Article
- Causes of regional variation in Dutch healthcare expenditures: Evidence from movers.Health economics · 2019Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In the Dutch health care system, health insurers negotiate with hospitals about the pricing of hospital products in a managed competition framework. In this paper, we study these contract prices that became for the first time publicly available in 2016. The data show substantive price variation between hospitals for the same products, and within a hospital for the same product across insurers. About 27% of the contract prices for a hospital product are at least 20% higher or lower than the average contract price in the market. For about half of the products, the highest and the lowest contract prices across hospitals differ by a factor of three or more. Moreover, hospital product prices do not follow a consistent ranking across hospitals, suggesting substantial cross-subsidization between hospital products. Potential explanations for the large and seemingly random price variation are: (i) different cost pricing methods used by hospitals, (ii) uncertainty due to frequent changes in the hospital payment system, (iii) price adjustments related to negotiated lumpsum payments and (iv) differences in hospital and insurer market power. Several policy options are discussed to reduce variation and increase transparency of hospital prices.
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