James D. Dana
John E. Kwoka, Kamran Moayed-Dadkhah
Date of Award
Doctor of Philosophy
Department or Academic Unit
College of Arts and Sciences. Department of Economics
economics, buyer power, dominant firm, entry, HMO, technology transfer
Health maintenance organizations - Finance, Medical economics
The following are abstracts of the three chapters of my doctoral dissertation entitled "Three Essays on Buyer Power Theory, Dominant HMOs, and Technology Transfer." The first chapter of my dissertation is an investigation into technological transfer efficacy, with success defined at specific levels culminating in revenue generation via licensing or a university-based start-up. Licensing revenue and new venture spin-offs as driven through U.S. university technology transfer offices have been a predominant goal for funded research and development over the last twenty-five years. However, as opposed to patent generation, investigation into the translation of research into viable revenue generation is somewhat sparse. The data used in the analysis is from 400 technology transfer disclosures filed over a ten-year period at a large U.S. research university. We estimate both ordered logit and ordered probit models which allow for our non-continuous, ordinal dependent variable. The results indicate that the significant factors in technology transfer success are the level of experience of the faculty member and participation in an industry sponsored research agreement. Aspects such as team size and academic department/school have no significant impact on technology transfer outcomes. The paper concludes with policy recommendations and directions for future research. The second chapter of my dissertation examines Health Maintenance Organizations' (HMO) entry decisions in local markets in Florida from 2001 to 2005. Unlike prior research, I analyze HMOs' entry decisions at the firm-level using a discrete-choice approach. I estimate the probability that an HMO will enter a market (HMO entry) as a function of firm characteristics, market characteristics and firm-market characteristics. The results indicate that both firm and market heterogeneity play a significant role in explaining HMO entry in local markets. Specifically, entry decisions in the Florida HMO Market vary substantially across individual HMOs. The geographic location of a HMO's existing operations, distance from a firm's headquarters and the type of firms already operating in a local market significantly impact HMOs' entry decisions. The importance of firm characteristics and firm-market characteristics suggests that some HMOs are better suited to a particular market than others. Thus it appears that HMOs are capitalizing upon the unique features of their organization or product when choosing which markets to enter in Florida. The third chapter of my dissertation examines the effects of Health Maintenance Organization (HMO) buyer power on both the price and utilization of hospital inpatient services by HMO enrollees. Currently, there are three conflicting theories regarding the effects of HMO buyer power: Monopsony Theory, Welfare-Increasing Theory, and the All-or-None Theory. I empirically test these theories using data from all general acute-care hospitals in Florida from 2001-2005. Unlike prior research, I control for HMO buyer power, measured as the market share of the largest HMO (Dominant HMO) or the level of HMO concentration (HMO HHI) in a given geographic region, in addition to HMO penetration, the share of a given market that is enrolled in HMOs. I estimate a reduced form model of the impact of HMO buyer power and HMO penetration on the price and quantity of hospital medical procedures and other supply and demand controls. I use instrumental variables to control for potential endogeneity of HMO penetration and HMO buyer power. I find that HMO buyer power has a significant negative effect on the price of inpatient hospital services for HMO enrollees and no impact on the number of hospital admissions or inpatient days per HMO enrollee. These results are only consistent with the All-or-None Theory of HMO buyer power.
Gay, Megan, "Three essays on buyer power theory, dominant HMOs and technology transfer" (2010). Economics Dissertations. Paper 2. http://hdl.handle.net/2047/d20000287
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