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- February 2025
- Article
Sale of Private Equity–Owned Physician Practices and Physician Turnover
By: Victoria Berquist, Lev Klarnet and Leemore Dafny
Private equity (PE) ownership of physician practices is increasing, with owners targeting sales, or exits, in 3 to 7 years. Little is known about the association of exit with physician retention and subsequent employment. Using panel data over the period 2014-2020, we... View Details
- 2025
- Working Paper
Sale of Private-Equity Owned Physician Practices and Physician Turnover
By: Leemore S. Dafny, Victoria Berquist and Lev Klarnet
- August 2024
- Article
How Do Copayment Coupons Affect Branded Drug Prices and Quantities Purchased?
By: Leemore S. Dafny, Kate Ho and Edward Kong
Drug copayment coupons to reduce patient cost-sharing have become nearly ubiquitous for high-priced brand-name prescription drugs. Medicare bans such coupons on the grounds that they are kickbacks that induce utilization, but they are commonly used by... View Details
- February 2024
- Case
Oak Street Health: From Start-up to Strategic Acquisition
By: Leemore S. Dafny and Thomas H. Lee
Oak Street Health opened its first primary care center for seniors in underserved communities in 2013. By 2022 the company had 169 centers and a market valuation exceeding $10 billion. Oak Street created value by accepting risk-adjusted, capitated payments for Medicare... View Details
- December 12, 2023
- Article
Prices for Common Services at Quaternary vs Nonquaternary Hospitals
By: Brandon W. Yan, Maximilian J. Pany and Leemore S. Dafny
Using commercial health insurance claims data from 2017-2019, we assessed whether quaternary hospitals charged higher prices for common, unspecialized services also offered by nonquaternary hospitals. We found quaternary-hospital price premiums of 8.2 percent, on... View Details
- August 10, 2023
- Editorial
A Conversation on the Draft Merger Guidelines
By: Cory S. Capps and Leemore Dafny
- Summer 2023
- Article
Do Policies to Increase Access to Treatment for Opioid Use Disorder Work?
By: Eric Barrette, Leemore S. Dafny and Karen Shen
Even among commercially insured individuals, opioid use disorder is undertreated in the United States: nearly half receive no treatment within six months of a new diagnosis. Using a difference-in-differences specification exploiting the extension of insurance parity... View Details
- May 4, 2023
- Article
Falling Insulin Prices—What Just Happened?
By: Leemore S. Dafny
Recently, more than 100 years after insulin was developed, manufacturers announced price reductions for insulin products. Pressure to reduce prices had long been building, so why would they act now? View Details
- October 2022 (Revised August 2024)
- Case
Cigna-Express Scripts: Can a Vertical Merger Rescue an Industry Under Attack?
By: Leemore Dafny
In Fall 2019, Cigna Corporation – a global health services company with a significant presence in the U.S. employer-sponsored health insurance market - was digesting its $54 billion acquisition of Express Scripts, Inc. (ESI), a pharmacy benefit manager (PBM)... View Details
- September 2022
- Article
Giving a Buck or Making a Buck? Donations by Pharmaceutical Manufacturers to Independent Patient Assistance Charities
By: Leemore Dafny, Christopher Ody and Teresa Rokos
The federal Anti-Kickback Statute prohibits biopharmaceutical manufacturers from directly covering Medicare enrollees’ out-of-pocket spending for the drugs they manufacture, but manufacturers may donate to independent patient assistance charities and earmark donations... View Details
- June 9, 2023
- Article
A Radical Treatment for Insulin Pricing
By: Leemore S. Dafny
In 2021, the Food and Drug Administration (FDA) approved the first interchangeable biosimilar for long-acting insulin, which many hoped would be substantially cheaper than the reference branded product. I explain why prices have barely changed, and argue that a... View Details
- March 31, 2022
- Article
Two Approaches to Capping Health Care Prices
By: Michael E. Chernew, Maximilian J. Pany and Leemore S. Dafny
High health care prices for the privately-insured contribute to high premiums, which put downward pressure on wages, and induce employers to reduce benefit generosity and charge employees more for coverage. As the average annual premium for family coverage currently... View Details
- Article
Regulating Hospital Prices Based on Market Concentration Is Likely to Leave High-Price Hospitals Unaffected
By: Maximilian J. Pany, Michael E. Chernew and Leemore S. Dafny
Concern about high hospital prices for commercially insured patients has motivated several proposals to regulate these prices. Such proposals often limit regulations to highly concentrated hospital markets. Using a large sample of 2017 US commercial insurance claims,... View Details
- Article
The Covid-19 Pandemic Should Not Delay Actions to Prevent Anticompetitive Consolidation in U.S. Health Care Markets
By: Leemore S. Dafny
This article describes potential regulatory and legislative reforms to assist antitrust enforcement agencies in halting anticompetitive acquisitions and practices, and preserving and promoting competition in health care markets. View Details
- 2021
- Government Testimony
How Health Care Consolidation Is Contributing to Higher Prices and Spending, and Reforms That Could Bolster Antitrust Enforcement and Preserve and Promote Competition in Health Care Markets
By: Leemore S. Dafny
Reforms to antitrust law and enforcement can help to address rising healthcare prices and spending. View Details
- March 9, 2021
- Article
Addressing Consolidation in Health Care Markets
By: Leemore S. Dafny
This Viewpoint proposes three steps the Biden administration can take to slow consolidation within health care, which has been shown to raise costs without improving service or quality: better fund federal antitrust enforcement agencies; appoint agency heads committed... View Details
- 2020
- Working Paper
Vertical Integration of Healthcare Providers Increases Self-Referrals and Can Reduce Downstream Competition: The Case of Hospital-Owned Skilled Nursing Facilities
By: David Cutler, Leemore S. Dafny, David Grabowski, Steven S. Lee and Christopher Ody
The landscape of the U.S. healthcare industry is changing dramatically as healthcare providers expand both within and across markets. While federal antitrust agencies have mounted several challenges to same-market combinations, they have not challenged any... View Details
- August 14, 2020
- Comment
How Has COVID-19 Affected Health Insurance Offered by Small Businesses in the U.S.? Early Evidence from a Survey
By: Leemore S. Dafny, Yin Wei Soon, Zoë Cullen and Christopher T. Stanton
As the COVID-19 pandemic stretches toward its third quarter, loss of health insurance coverage has not figured prominently in the public debate. Data in this report demonstrate why that is, but also suggest that the apparent stability is fragile, with potentially... View Details
- Article
Treatment Of Opioid Use Disorder Among Commercially Insured U.S. Adults, 2008–17
By: Karen Shen, Eric Barrette and Leemore S. Dafny
There is abundant literature on efforts to reduce opioid prescriptions and misuse, but comparatively little on the treatment provided to people with opioid use disorder (OUD). Using claims data representing 12–15 million nonelderly adults covered through commercial... View Details