Hospital Competition, Vertical Integration, and Participation in Value-Based Payment Programs

The US hospital market has become increasingly concentrated through extensive vertical and horizontal consolidation over the past decades. This study aims to examine whether hospital market competition and hospital-physician vertical integration are separately and jointly associated with hospitals’ participation in value-based payment programs. This study will provide new evidence on the relationship between hospital competition and VBP participation, overall and across different payers, and on how the relationship varies across hospitals’ levels of integration with physicians.