Administered Pricing and Vertical Integration in the Hospital Industry
研究了美国Medicare计划下的政府支付机制如何影响医院与养老院之间的合同关系及纵向一体化，发现1983年实施的预付费制度促使医院缩短住院时间，从而依赖养老院，但养老院接收病人的价格由Medicare单方面设定，而非双方协商。
This article investigates the influence of governmental payment mechanisms under the Medicare program on contractual relationships and vertical integration between hospitals and nursing homes. The "prospective payment system," implemented in 1983, created strong incentives for hospitals to reduce costs per admission by shortening the average length of patient stays, which in turn created a new dependency of hospitals on nursing homes. In contrast to the bilateral contract negotiations which resolve analogous problems in other industries, the price paid to the nursing home to accept a hospital patient cannot be negotiated between the hospital and the nursing home but is established unilaterally by Medicare. However, Medicare does not determine the implicit transfer price governing patient flows between the hospital and nursing home divisions of vertically integrated health care organizations. The impact of administered pricing on vertical integration is confirmed empirically using 1982-90 data on acute care hospitals and skilled nursing facilities.