Who Benefits from Market Concentration? The Effects of Hospital Mergers on Physician Income

Jan Boone, Martin Salm and Sofia Santin

No 22025, CEPR Discussion Papers from Centre for Economic Policy Research

Abstract: We examine the effect of hospital mergers on the income of medical specialists, with a specific focus on how this effect varies across different contractual arrangements between hospitals and medical specialists. We analyze the effects of 17 mergers that occurred in the Netherlands between 2011 and 2018. Using administrative data and employing a difference-in-differences empirical approach, we find that hospital mergers increase the income of self-employed medical specialists by 3.86\% and do not affect the income of salaried medical specialists. Among the self-employed, mergers lead to significant income increases for men, more senior physicians, and those with the highest incomes prior to the merger. These results are in line with our theoretical model. Furthermore, we do not find significant effects on hospital expenditures and 30-day mortality, but a reduction in hospital admissions and the number of physicians.

Keywords: physician income; Bargaining power; Hospital mergers; medical specialists (search for similar items in EconPapers)
JEL-codes: I11 J31 L44 (search for similar items in EconPapers)
Date: 2026-10
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