Evaluating Substitutes for Federal Antitrust: The Case of COPAs

Seungwhan Chun, Marco Duarte, Cici McNamara and Jason Lindo

No 34373, NBER Working Papers from National Bureau of Economic Research, Inc

Abstract: Are state-imposed behavioral remedies effective substitutes for federal antitrust enforcement? We evaluate state regulation of hospital mergers under Certificates of Public Advantage (COPAs). Using hospital data from 1996-2022, we compare COPA-regulated mergers to unregulated mergers with similar anticompetitive potential. In highly concentrated markets, COPA mergers result in 11.1 p.p. lower price growth but 0.5 p.p. greater increases in 30-day mortality rates. We find a negative correlation between price and mortality effects for COPA mergers, consistent with theoretical predictions that binding price caps exacerbate quality deterioration. Our findings suggest that COPA contracts are poor substitutes for traditional antitrust enforcement.

JEL-codes: G38 I11 K21 (search for similar items in EconPapers)
Date: 2025-10
New Economics Papers: this item is included in nep-bec, nep-com, nep-hea, nep-ind, nep-law and nep-reg
Note: EH IO LE
References: Add references at CitEc
Citations:

Downloads: (external link)
http://www.nber.org/papers/w34373.pdf (application/pdf)
Access to the full text is generally limited to series subscribers, however if the top level domain of the client browser is in a developing country or transition economy free access is provided. More information about subscriptions and free access is available at http://www.nber.org/wwphelp.html. Free access is also available to older working papers.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:nbr:nberwo:34373

Ordering information: This working paper can be ordered from
http://www.nber.org/papers/w34373
The price is Paper copy available by mail.

Access Statistics for this paper

More papers in NBER Working Papers from National Bureau of Economic Research, Inc National Bureau of Economic Research, 1050 Massachusetts Avenue Cambridge, MA 02138, U.S.A.. Contact information at EDIRC.
Bibliographic data for series maintained by ().