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    • All HBS Web  (107,748)
      • Faculty Publications  (51)

      Dafny, Leemore S. Remove Dafny, Leemore S. →

      Page 1 of 51 Results →
      • October 2022
      • Case

      Cigna-Express Scripts: Can a Vertical Merger Rescue an Industry Under Attack?

      By: Leemore Dafny
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      Dafny, Leemore. "Cigna-Express Scripts: Can a Vertical Merger Rescue an Industry Under Attack?" Harvard Business School Case 323-038, October 2022.
      • 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
      Keywords: Cost Sharing; Prescription Drugs; Drug Spending; Medicare; Dual Eligibility; Cost; Health Care and Treatment; Philanthropy and Charitable Giving; Pharmaceutical Industry
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      Dafny, Leemore, Christopher Ody, and Teresa Rokos. "Giving a Buck or Making a Buck? Donations by Pharmaceutical Manufacturers to Independent Patient Assistance Charities." Health Affairs 41, no. 9 (September 2022).
      • 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
      Keywords: Price Caps; Health Care and Treatment; Price
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      Chernew, Michael E., Maximilian J. Pany, and Leemore S. Dafny. "Two Approaches to Capping Health Care Prices." Health Affairs Forefront (March 31, 2022).
      • 2022
      • Working Paper

      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
      Keywords: Prescription Drugs; Coupons; Impact; Health Care and Treatment; Markets; Price; Spending; Pharmaceutical Industry; United States
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      Dafny, Leemore S., Kate Ho, and Edward Kong. "How Do Copayment Coupons Affect Branded Drug Prices and Quantities Purchased?" NBER Working Paper Series, No. 29735, February 2022.
      • 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
      Keywords: Health Care Providers; Hospitals; Insurance Market Regulation; Price Regulation; Markets; Health Care and Treatment; Cost; Quality; Insurance; Price; Governing Rules, Regulations, and Reforms
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      Pany, Maximilian J., Michael E. Chernew, and Leemore S. Dafny. "Regulating Hospital Prices Based on Market Concentration Is Likely to Leave High-Price Hospitals Unaffected." Health Affairs 40, no. 9 (September 2021): 1386–1394.
      • 2021
      • Working Paper

      Do Policies to Increase Access to Treatment for Opioid Use Disorder Work?

      By: Eric Barrette, Leemore S. Dafny and Karen Shen
      As of 2016 there were an estimated 2.1 million Americans suffering from opioid use disorder (OUD). To date, most policy interventions have focused on curbing opioid prescriptions and extending insurance coverage to include substance use disorder. However, relatively...  View Details
      Keywords: Opioid Treatment; Medication-assisted Treatment; Substance Use Disorder; Private Insurance; Health Care and Treatment; Health Disorders; Insurance; United States
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      Barrette, Eric, Leemore S. Dafny, and Karen Shen. "Do Policies to Increase Access to Treatment for Opioid Use Disorder Work?" NBER Working Paper Series, No. 29001, July 2021.
      • 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
      Keywords: Health Care and Treatment; Markets; Competition; Governing Rules, Regulations, and Reforms
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      Dafny, Leemore S. "The Covid-19 Pandemic Should Not Delay Actions to Prevent Anticompetitive Consolidation in U.S. Health Care Markets." Promarket (June 10, 2021).
      • 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
      Keywords: Antitrust Law; Health Care and Treatment; Consolidation; Price; Spending; Cost Management; Governing Rules, Regulations, and Reforms; Competition; United States
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      Dafny, Leemore S. "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." Government Testimony, Washington, DC, United States, April 2021.
      • 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
      Keywords: Antitrust Issues And Policies; Health Care and Treatment; Markets; Consolidation; Competition; Government Administration
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      Dafny, Leemore S. "Addressing Consolidation in Health Care Markets." JAMA, the Journal of the American Medical Association 325, no. 10 (March 9, 2021): 927–928.
      • 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
      Keywords: Antitrust; Health Care and Treatment; Vertical Integration; Organizational Structure; Competition; Health Industry; United States
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      Cutler, David, Leemore S. Dafny, David Grabowski, Steven S. Lee, and Christopher Ody. "Vertical Integration of Healthcare Providers Increases Self-Referrals and Can Reduce Downstream Competition: The Case of Hospital-Owned Skilled Nursing Facilities." NBER Working Paper Series, No. 28305, December 2020.
      • 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
      Keywords: Health Pandemics; Health Care and Treatment; Insurance; Small Business; Surveys; United States
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      Dafny, Leemore S., Yin Wei Soon, Zoë Cullen, and Christopher T. Stanton. "How Has COVID-19 Affected Health Insurance Offered by Small Businesses in the U.S.? Early Evidence from a Survey." NEJM Catalyst (August 14, 2020). (Commentary.)
      • 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
      Keywords: Opioid Treatment; Medication-assisted Treatment; Substance Use Disorder; Private Insurance; Health Disorders; Health Care and Treatment; Insurance; United States
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      Shen, Karen, Eric Barrette, and Leemore S. Dafny. "Treatment Of Opioid Use Disorder Among Commercially Insured U.S. Adults, 2008–17." Health Affairs 39, no. 6 (June 2020): 993–1001.
      • May 21, 2020
      • Editorial

      Primary Care Is Hurting: Why Aren't Private Insurers Pitching In?

      By: Leemore S. Dafny and J. Michael McWilliams
      Primary care clinicians are the front line for patients with suspected infection. We rely on them to diagnose, triage, and manage patients with potential or confirmed COVID infections. They are also responsible for keeping non-COVID medical conditions under control...  View Details
      Keywords: COVID-19; Primary Care; Health Pandemics; Health Care and Treatment; Financial Condition; Insurance
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      Dafny, Leemore S., and J. Michael McWilliams. "Primary Care Is Hurting: Why Aren't Private Insurers Pitching In?" Health Affairs Blog (May 21, 2020).
      • April 15, 2020
      • Other Article

      Designating Certain Post-Acute Care Facilities As COVID-19 Skilled Care Centers Can Increase Hospital Capacity And Keep Nursing Home Patients Safer

      By: Leemore S. Dafny and Steven S. Lee
      As the number of COVID-19 cases nationwide continues to grow, many hospitals will need to convert acute care beds into intensive care beds and discharge stable patients to post-acute care settings such as nursing homes. In addition, nursing homes unable to care for...  View Details
      Keywords: COVID-19; Nursing Homes; Health Pandemics; Health Care and Treatment; Safety; Quality
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      Dafny, Leemore S., and Steven S. Lee. "Designating Certain Post-Acute Care Facilities As COVID-19 Skilled Care Centers Can Increase Hospital Capacity And Keep Nursing Home Patients Safer." Health Affairs Blog (April 15, 2020).
      • 2020
      • Chapter

      Health Care Markets a Decade After the ACA: Bigger, but Probably Not Better

      By: Leemore S. Dafny
      Love it or hate it, the Affordable Care Act (ACA) embraced and extended the role of private markets in financing and delivering health care in the United States. Ten years after the ACA’s passage, it is unclear whether health care markets are better (along a range of...  View Details
      Keywords: Health Care and Treatment; Markets; Laws and Statutes; Outcome or Result; Health Industry; United States
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      Dafny, Leemore S. "Health Care Markets a Decade After the ACA: Bigger, but Probably Not Better." Chap. 15 in The Trillion Dollar Revolution: How the Affordable Care Act Transformed Politics, Law, and Health Care in America, edited by Ezekiel J. Emanuel and Abbe R. Gluck. New York: PublicAffairs, 2020.
      • January 2, 2020
      • Article

      Changes in Quality of Care After Hospital Mergers and Acquisitions

      By: Nancy Dean Beaulieu, Leemore S. Dafny, B. E. Landon, Jesse Dalton, Ifedayo Kuye and J. Michael McWilliams
      Background: The hospital industry has consolidated substantially during the past two decades and at an accelerated pace since 2010. Multiple studies have shown that hospital mergers have led to higher prices for commercially insured patients, but research about effects...  View Details
      Keywords: Hospitals; Mergers and Acquisitions; Health Care and Treatment; Quality
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      Beaulieu, Nancy Dean, Leemore S. Dafny, B. E. Landon, Jesse Dalton, Ifedayo Kuye, and J. Michael McWilliams. "Changes in Quality of Care After Hospital Mergers and Acquisitions." New England Journal of Medicine 382, no. 1 (January 2, 2020): 51–59.
      • Summer 2019
      • Article

      The Price Effects of Cross-Market Mergers: Theory and Evidence from the Hospital Industry

      By: Leemore S. Dafny, Katherine Ho and Robin S. Lee
      We consider the effect of mergers between firms whose products are not viewed as direct substitutes for the same good or service but are bundled by a common intermediary. Focusing on hospital mergers across distinct geographic markets, we show that such combinations...  View Details
      Keywords: Mergers and Acquisitions; Markets; Geographic Scope; Price; Outcome or Result; Insurance; Health Industry
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      Dafny, Leemore S., Katherine Ho, and Robin S. Lee. "The Price Effects of Cross-Market Mergers: Theory and Evidence from the Hospital Industry." RAND Journal of Economics 50, no. 2 (Summer 2019): 286–325.
      • February 2019
      • Article

      Does It Matter If Your Health Insurer Is For Profit? Effects of Ownership on Premiums, Insurance Coverage, and Medical Spending

      By: Leemore S. Dafny
      There is limited empirical evidence about the impact of for-profit health insurers on various outcomes. I study the effects of conversions to for-profit status by Blue Cross Blue Shield (BCBS) affiliates in 11 states, spanning 28 geographic markets. I find both the...  View Details
      Keywords: Health Insurance; Medical Loss Ratio; Blue Cross; Corporate Governance; Health; Insurance; For-Profit Firms; Insurance Industry; United States
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      Dafny, Leemore S. "Does It Matter If Your Health Insurer Is For Profit? Effects of Ownership on Premiums, Insurance Coverage, and Medical Spending." American Economic Journal: Economic Policy 11, no. 1 (February 2019): 222–265.
      • Article

      Decreases In Readmissions Credited to Medicare's Program to Reduce Hospital Readmissions Have Been Overstated

      By: Christopher Ody, Lucy Msall, Leemore S. Dafny, David Grabowski and David Cutler
      Medicare’s Hospital Readmissions Reduction Program (HRRP) has been credited with lowering risk-adjusted readmission rates for targeted conditions at general acute care hospitals. However, these reductions appear to be illusory or overstated. This is because a...  View Details
      Keywords: Readmission Rates; Hospitals; Acute Care Hospitals; Medicare; Myocardial Infarction; Heart Failure; Health Care and Treatment
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      Ody, Christopher, Lucy Msall, Leemore S. Dafny, David Grabowski, and David Cutler. "Decreases In Readmissions Credited to Medicare's Program to Reduce Hospital Readmissions Have Been Overstated." Health Affairs 38, no. 1 (January 2019): 36–43.
      • October 2018 (Revised August 2019)
      • Case

      Beth Israel Deaconess: Consolidating to Strengthen, or to Stave Off, Competition?

      By: Leemore Dafny
      In July 2017, CEO Kevin Tabb of Boston's Beth Israel Deaconess Medical Center announced his plan to consolidate 11 Massachusetts hospitals under a common management structure. These hospitals collectively generated $5 billion in patient revenue and 25% of...  View Details
      Keywords: Beth Israel Deaconess; Lahey; Partners; Health Care; Hospitals; Payers; Providers; Anti-trust; Health Care Regulation; Mergers and Acquisitions; Health Care and Treatment; Market Design; Duopoly and Oligopoly; Negotiation; Consolidation; Competition; Health Industry; Massachusetts; Boston
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      Dafny, Leemore. "Beth Israel Deaconess: Consolidating to Strengthen, or to Stave Off, Competition?" Harvard Business School Case 319-026, October 2018. (Revised August 2019.)
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