Competition, quality and integrated health care

Abstract

Integration of health care services has been promoted in several countries to improve the quality and coordination of care. We investigate the effects of such integration in a model where providers compete on quality to attract patients under regulated prices. We identify circumstances under which integration either increases or reduces the quality of services provided. In the absence of synergies related to costs or benefits, integration generally leads to increases in quality for some services and reductions for others. The corresponding effect on health benefits depends largely on whether integration leads to quality dispersion or convergence across services.