Skip to main content

Main menu

  • Home
  • Content
    • Current
    • Ahead of print
    • Archive
    • Supplementary Material
    • Free Issue
    • Special Issues
  • Info for
    • Authors
    • Subscribers
    • Institutions
    • Advertisers
  • About Us
    • About Us
    • Editorial Board
  • Connect
    • Feedback
    • Help
    • Request JHR at your library
    • Alerts
  • Announcements
  • Special Issue
  • Other Publications
    • UW Press Journals

User menu

  • Register
  • Subscribe
  • My alerts
  • Log in
  • My Cart

Search

  • Advanced search
Journal of Human Resources
  • Other Publications
    • UW Press Journals
  • Register
  • Subscribe
  • My alerts
  • Log in
  • My Cart
Journal of Human Resources

Advanced Search

  • Home
  • Content
    • Current
    • Ahead of print
    • Archive
    • Supplementary Material
    • Free Issue
    • Special Issues
  • Info for
    • Authors
    • Subscribers
    • Institutions
    • Advertisers
  • About Us
    • About Us
    • Editorial Board
  • Connect
    • Feedback
    • Help
    • Request JHR at your library
    • Alerts
  • Announcements
  • Special Issue
  • Follow uwp on Twitter
  • Follow JHR on Bluesky
Research ArticleArticles

Owning the Agent

Hospital Influence on Physician Behaviors

Haizhen Lin, Ian M. McCarthy, Michael Richards and Christopher Whaley
Published online before print May 09, 2025, 0723-13024R2; DOI: https://doi.org/10.3368/jhr.0723-13024R2
Haizhen Lin
University & NBER
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ian M. McCarthy
Emory University & NBER
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michael Richards
Cornell University & NBER
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Christopher Whaley
Brown University
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • References
  • PDF
Loading

References

    1. Afendulis, Christopher C., &
    2. Kessler, Daniel P.
    2007. Tradeoffs from Integrating Diagnosis and Treatment in Markets for Health Care. American Economic Review, 97(3), 1013–1020.
    OpenUrlCrossRefPubMed
    1. Aron-Dine, Aviva,
    2. Einav, Liran, &
    3. Finkelstein, Amy.
    2013. The RAND Health Insurance Experiment, Three Decades Later. Journal of Economic Perspectives, 27(1), 197–222. Publisher: American Economic Association.
    OpenUrlCrossRefPubMed
    1. Baicker, Katherine, &
    2. Chandra, Amitabh.
    2004. Medicare Spending, The Physician Workforce, And Beneficiaries’ Quality Of Care. Health Affairs, 23(3), 291.
    OpenUrl
    1. Baker, Laurence C,
    2. Bundorf, M Kate, &
    3. Kessler, Daniel P.
    2014. Vertical integration: hospital ownership of physician practices is associated with higher prices and spending. Health Affairs, 33(5), 756–763.
    OpenUrlAbstract/FREE Full Text
    1. Baker, Laurence C,
    2. Bundorf, M Kate, &
    3. Kessler, Daniel P.
    2016a. The Effect of Hospital/Physician Integration on Hospital Choice. Journal of Health Economics, 50, 1–8.
    OpenUrlCrossRefPubMed
    1. Baker, Laurence C.,
    2. Bundorf, M. Kate, &
    3. Royalty, Anne.
    2016b. Measuring Physician Practice Competition Using Medicare Data. Pages 351–377 of: Measuring and Modeling Health Care Costs. University of Chicago Press.
    1. Cabral, Marika, &
    2. Mahoney, Neale.
    2019. Externalities and Taxation of Supplemental Insurance: A Study of Medicare and Medigap. American Economic Journal: Applied Economics, 11(2), 37–73.
    OpenUrlCrossRefPubMed
    1. Callaway, Brantly, &
    2. Sant’Anna, Pedro H. C.
    2021. Difference-in-Differences with multiple time periods. Journal of Econometrics, 225(2), 200–230.
    OpenUrlCrossRef
    1. Capps, Cory,
    2. Dranove, David, &
    3. Ody, Christopher.
    2018. The effect of hospital acquisitions of physician practices on prices and spending. Journal of health economics, 59, 139–152. Publisher: Elsevier.
    OpenUrlCrossRefPubMed
    1. Carlin, Caroline S,
    2. Dowd, Bryan, &
    3. Feldman, Roger.
    2015. Changes in quality of health care delivery after vertical integration. Health services research, 50(4), 1043–1068. Publisher: Wiley Online Library.
    OpenUrlCrossRefPubMed
    1. Carlin, Caroline S.,
    2. Feldman, Roger, &
    3. Dowd, Bryan.
    2016. The Impact of Hospital Acquisition of Physician Practices on Referral Patterns. Health Economics, 25(4), 439–454.
    OpenUrlCrossRefPubMed
    1. Chernew, Michael,
    2. Cooper, Zack,
    3. Hallock, Eugene Larsen, &
    4. Scott Morton, Fiona.
    2021. Physician agency, consumerism, and the consumption of lower-limb MRI scans. Journal of Health Economics, 76(Mar.), 102427.
    OpenUrlCrossRefPubMed
    1. Ciliberto, Federico, &
    2. Dranove, David.
    2006. The effect of physician–hospital affiliations on hospital prices in California. Journal of Health Economics, 25(1), 29–38. Publisher: Elsevier.
    OpenUrlCrossRefPubMedWeb of Science
    1. Clemens, Jeffrey, &
    2. Gottlieb, Joshua D.
    2014. Do Physicians’ Financial Incentives Affect Medical Treatment and Patient Health? American Economic Review, 104(4), 1320–1349.
    OpenUrlCrossRefPubMed
    1. Craig, Stuart V.,
    2. Grennan, Matthew, &
    3. Swanson, Ashley.
    2021. Mergers and marginal costs: New evidence on hospital buyer power. The RAND Journal of Economics, 52(1), 151–178. _eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1111/1756-2171.12365.
    OpenUrlCrossRef
    1. Cuellar, Alison Evans, &
    2. Gertler, Paul J.
    2006. Strategic integration of hospitals and physicians. Journal of Health Economics, 25(1), 1–28. Publisher: Elsevier.
    OpenUrlCrossRefPubMedWeb of Science
    1. Cuesta, José Ignacio,
    2. Noton, Carlos, &
    3. Vatter, Benjamin.
    2019 (Jan.). Vertical Integration between Hospitals and Insurers.
    1. Curto, Vilsa,
    2. Einav, Liran,
    3. Finkelstein, Amy,
    4. Levin, Jonathan, &
    5. Bhattacharya, Jay.
    2019. Health Care Spending and Utilization in Public and Private Medicare. American Economic Journal: Applied Economics, 11(2), 302–332.
    OpenUrlCrossRefPubMed
    1. Danagoulian, Shooshan, &
    2. Wilk, Thomas A.
    2022. Locking out prevention: Dental care in the midst of a pandemic. Health Economics, 31(9), 1973–1992. _eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1002/hec.4558.
    OpenUrlCrossRefPubMed
    1. Dranove, David, &
    2. Ody, Christopher.
    2019. Employed for higher pay? How Medicare facility fees affect hospital employment of physicians. American Economics Journal: Economic Policy, 11(4), 249–271.
    OpenUrlCrossRef
    1. Dummit, Laura A,
    2. Kahvecioglu, Daver,
    3. Marrufo, Grecia,
    4. Rajkumar, Rahul,
    5. Marshall, Jaclyn,
    6. Tan, Eleonora,
    7. Press, Matthew J,
    8. Flood, Shannon,
    9. Muldoon, L Daniel,
    10. Gu, Qian, & others
    . 2016. Association between hospital participation in a Medicare bundled payment initiative and payments and quality outcomes for lower extremity joint replacement episodes. JAMA, 316(12), 1267–1278. Publisher: American Medical Association.
    OpenUrlCrossRefPubMed
    1. Einav, Liran,
    2. Finkelstein, Amy, &
    3. Polyakova, Maria.
    2018. Private Provision of Social Insurance: Drug-Specific Price Elasticities and Cost Sharing in Medicare Part D. American Economic Journal: Economic Policy, 10(3), 122–153.
    OpenUrlCrossRefPubMed
    1. Ellimoottil, Chad,
    2. Ryan, Andrew M,
    3. Hou, Hechuan,
    4. Dupree, James M,
    5. Hallstrom, Brian, &
    6. Miller, David C.
    2017. Implications of the definition of an episode of care used in the comprehensive care for joint replacement model. JAMA surgery, 152(1), 49–54. Publisher: American Medical Association.
    OpenUrlCrossRefPubMed
    1. Ellis, Randall P, &
    2. McGuire, Thomas G.
    1996. Hospital response to prospective payment: moral hazard, selection, and practice-style effects. Journal of Health Economics, 15(3), 257–277. Publisher: Elsevier.
    OpenUrlCrossRefPubMedWeb of Science
    1. Finkelstein, Amy, &
    2. McGarry, Kathleen.
    2006. Multiple dimensions of private information: evidence from the long-term care insurance market. American Economic Review, 96(4), 938–958. Publisher: Princeton, NJ: American Economic Association, 1911-.
    OpenUrlCrossRefPubMed
    1. Finkelstein, Amy,
    2. Gentzkow, Matthew, &
    3. Williams, Heidi.
    2016. Sources of Geographic Variation in Health Care: Evidence From Patient Migration. The Quarterly Journal of Economics, 131(4), 1681–1726. Publisher: Oxford University Press.
    OpenUrlCrossRefPubMed
    1. Gaynor, M, &
    2. Town, R.
    2012. Competition in Health Care Markets. In: Pauly, M., McGuire, T., & Pita Barros, P. (eds), Handbook of Health Economics, vol. 2. Amsterdam: Elsevier.
    1. Gaynor, M,
    2. Ho, K, &
    3. Town, R.
    2015. The Industrial Organization of Health Care Markets. Journal of Economic Literature, 47(2), 235–284.
    OpenUrl
    1. Gaynor, Martin, &
    2. Gertler, Paul.
    1995. Moral hazard and risk spreading in partnerships. The RAND Journal of Economics, 26(4), 591–613. Publisher: JSTOR.
    OpenUrlCrossRefWeb of Science
    1. Goldsmith-Pinkham, Paul,
    2. Sorkin, Isaac, &
    3. Swift, Henry.
    2020. Bartik Instruments: What, When, Why, and How. American Economic Review, 110(8), 2586–2624.
    OpenUrlCrossRef
    1. Gottlieb, Daniel J,
    2. Zhou, Weiping,
    3. Song, Yunjie,
    4. Andrews, Kathryn Gilman,
    5. Skinner, Jonathan S, &
    6. Sutherland, Jason M.
    2010. Prices don’t drive regional Medicare spending variations. Health Affairs, 29(3), 537–543.
    OpenUrlAbstract/FREE Full Text
    1. Gowrisankaran, Gautam,
    2. Nevo, Aviv, &
    3. Town, Robert.
    2015. Mergers When Prices Are Negotiated: Evidence from the Hospital Industry. American Economic Review, 105(1), 172–203.
    OpenUrlCrossRef
    1. Gruber, Jonathan, &
    2. Owings, Maria.
    1996. Physician financial incentives and cesarean section delivery. The RAND Journal of Economics, 27(1), 99–123.
    OpenUrlCrossRefPubMedWeb of Science
    1. Ho, Kate, &
    2. Lee, Robin S.
    2017. Insurer competition in health care markets. Econometrica, 85(2), 379–417. Publisher: Wiley Online Library.
    OpenUrlCrossRef
    1. Iizuka, Toshiaki.
    2012. Physician agency and adoption of generic pharmaceuticals. American Economic Review, 102(6), 2826–58.
    OpenUrlCrossRefPubMed
    1. Koch, Thomas G,
    2. Wendling, Brett W, &
    3. Wilson, Nathan E.
    2017. How vertical integration affects the quantity and cost of care for Medicare beneficiaries. Journal of Health Economics, 52, 19–32. Publisher: Elsevier.
    OpenUrlCrossRefPubMed
    1. Koch, Thomas G.,
    2. Wendling, Brett W., &
    3. Wilson, Nathan E.
    2021. The Effects of Physician and Hospital Integration on Medicare Beneficiaries’ Health Outcomes. The Review of Economics and Statistics, 103(4), 725–739.
    OpenUrl
    1. Kocher, Robert, &
    2. Sahni, Nikhil R.
    2011. Hospitals’ race to employ physicians—the logic behind a money-losing proposition. New England Journal of Medicine, 364(19), 1790–1793. Publisher: Mass Medical Soc.
    OpenUrlCrossRefPubMedWeb of Science
    1. Lin, Haizhen,
    2. McCarthy, Ian M., &
    3. Richards, Michael.
    2021. Hospital Pricing Following Integration with Physician Practices. Journal of Health Economics, 77(May), 102444.
    OpenUrlCrossRefPubMed
    1. Madison, Kristin.
    2004. Hospital–physician affiliations and patient treatments, expenditures, and outcomes. Health services research, 39(2), 257–278. Publisher: Wiley Online Library.
    OpenUrlCrossRefPubMed
    1. Maurer, Kristin A.,
    2. Blue, Laura,
    3. Orzol, Sean,
    4. Morrison Hensleigh, Nikkilyn, &
    5. Peikes, Deborah
    . 2021. Measuring physician practice site characteristics: A comparison of data from SK&A and a practice site survey. Health Services Research, 56(2), 334–340.
    OpenUrlCrossRefPubMed
    1. Mechanic, Robert E.
    2015. Mandatory Medicare bundled payment—is it ready for prime time? New England Journal of Medicine, 373(14), 1291–1293. Publisher: Mass Medical Soc.
    OpenUrlCrossRefPubMed
    1. Molitor, David.
    2018. The evolution of physician practice styles: evidence from cardiologist migration. American Economic Journal: Economic Policy, 10(1), 326–56.
    OpenUrlCrossRefPubMed
    1. Neprash, Hannah T,
    2. Chernew, Michael E,
    3. Hicks, Andrew L,
    4. Gibson, Teresa, &
    5. McWilliams, J Michael.
    2015. Association of financial integration between physicians and hospitals with commercial health care prices. JAMA internal medicine, 175(12), 1932–1939.
    OpenUrlCrossRefPubMed
    1. Post, Brady,
    2. Buchmueller, Tom, &
    3. Ryan, Andrew M.
    2018. Vertical integration of hospitals and physicians: Economic theory and empirical evidence on spending and quality. Medical Care Research and Review, 75(4), 399–433. Publisher: SAGE Publications Sage CA: Los Angeles, CA.
    OpenUrlCrossRefPubMed
    1. Post, Brady,
    2. Hollenbeck, Brent K.,
    3. Norton, Edward C., &
    4. Ryan, Andrew M.
    2023. Hospital-physician integration and clinical volume in traditional Medicare. Health Services Research.
    1. Richards, Michael R.,
    2. Seward, Jonathan A., &
    3. Whaley, Christopher M.
    2021. Removing Medicare’s outpatient ban and Medicare and private surgical trends. The American Journal of Managed Care, 27(3), 104–108.
    OpenUrlCrossRefPubMed
    1. Richards, Michael R.,
    2. Seward, Jonathan A., &
    3. Whaley, Christopher M.
    2022. Treatment consolidation after vertical integration: Evidence from outpatient procedure markets. Journal of Health Economics, 81(Jan.), 102569.
    OpenUrlCrossRefPubMed
    1. Skinner, Jonathan, &
    2. Fisher, Elliott.
    1997. Regional disparities in Medicare expenditures: an opportunity for reform. National Tax Journal, 50(3), 413–425.
    OpenUrlCrossRef
    1. Starc, Amanda, &
    2. Town, Robert J.
    2020. Externalities and Benefit Design in Health Insurance. The Review of Economic Studies, 87(6), 2827–2858.
    OpenUrlCrossRef
    1. Walden, Emily.
    2016. Can Hospitals Buy Referrals? The Impact of Physician Group Acquisitions on Market-Wide Referral Patterns. Working Paper. University of Wisconsin, Madison.
    1. Wennberg, John, &
    2. Gittelsohn, Alan.
    1973. Small area variations in health care delivery: a populationbased health information system can guide planning and regulatory decision-making. Science, 182(4117), 1102–1108.
    OpenUrlAbstract/FREE Full Text
    1. Wennberg, John E.,
    2. Fisher, Elliott S., &
    3. Skinner, Jonathan S.
    2004. Geography And The Debate Over Medicare Reform. Health Affairs, W96–W114. Num Pages: 19 Place: Chevy Chase, United States Publisher: The People to People Health Foundation, Inc., Project HOPE Section: MEDICARE.
    1. Whaley, Christopher M., &
    2. Zhao, Xiaoxi.
    2024. The effects of physician vertical integration on referral patterns, patient welfare, and market dynamics. Journal of Public Economics, 238(Oct.), 105175.
    OpenUrlCrossRefPubMed
    1. Whaley, Christopher M,
    2. Zhao, Xiaoxi,
    3. Richards, Michael, &
    4. Damberg, Cheryl L.
    2021. Higher Medicare Spending on Imaging and Lab Services after Primary Care Physician Group Vertical Integration. Health Affairs, 40(5), 702–709.
    OpenUrlCrossRefPubMed
    1. Young, Gary J,
    2. Zepeda, E David,
    3. Flaherty, Stephen, &
    4. Thai, Ngoc.
    2021. Hospital Employment of Physicians in Massachusetts Is Associated with Inappropriate Diagnostic Imaging. Health Affairs, 40(5), 710–718. Publisher: Health Affairs.
    OpenUrlCrossRefPubMed
    1. Zhang, Jonathan,
    2. Chen, Yiwei,
    3. Einav, Liran,
    4. Levin, Jonathan, &
    5. Bhattacharya, Jay.
    2021. Consolidation of primary care physicians and its impact on healthcare utilization. Health Economics, 30(6), 1361–1373.
    OpenUrlCrossRefPubMed
PreviousNext
Back to top

In this issue

Journal of Human Resources: 61 (4)
Journal of Human Resources
Vol. 61, Issue 4
1 Jul 2026
  • Table of Contents
  • Table of Contents (PDF)
  • Cover (PDF)
  • Index by author
  • Front Matter (PDF)
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on Journal of Human Resources.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Owning the Agent
(Your Name) has sent you a message from Journal of Human Resources
(Your Name) thought you would like to see the Journal of Human Resources web site.
Citation Tools
Owning the Agent
Haizhen Lin, Ian M. McCarthy, Michael Richards, Christopher Whaley
Journal of Human Resources May 2025, 0723-13024R2; DOI: 10.3368/jhr.0723-13024R2

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Owning the Agent
Haizhen Lin, Ian M. McCarthy, Michael Richards, Christopher Whaley
Journal of Human Resources May 2025, 0723-13024R2; DOI: 10.3368/jhr.0723-13024R2
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
Bookmark this article

Jump to section

  • Article
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • References
  • PDF

Related Articles

  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Selection into Public Service
  • Monopsony, Efficiency, and the Regularization of Undocumented Immigrants
  • Migration, Segregation, and Interracial Marriage
Show more Articles

Similar Articles

UW Press logo

© 2026 Board of Regents of the University of Wisconsin System

Powered by HighWire