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Exploring differences between private and public prices in the English care homes market

Published online by Cambridge University Press:  03 February 2020

Stephen Allan ,
Katerina Gousia  and
Julien Forder
Stephen Allan*
Affiliation:
PSSRU, University of Kent, Cornwallis Building, Canterbury, CT2 7NF, UK
Katerina Gousia
Affiliation:
PSSRU and CHSS, University of Kent, Canterbury, UK
Julien Forder
Affiliation:
PSSRU, SSPSSR, University of Kent, Canterbury, UK
*
*Corresponding author. Email: s.allan@kent.ac.uk
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Abstract

This work quantitatively assesses the potential reasons behind the difference in prices paid by care home residents in England. Evidence suggests that the price paid by private payers is higher than that paid for publicly supported residents, and this is often attributed to the market power wielded by local authorities as the dominant purchaser in local markets. Estimations of private prices at the local authority level are used to assess the difference in price paid between private and public prices, the fees gap, using data from 2008 to 2010. Controlling for local area and average care home characteristics, the results indicate that both care home and local authority market power play a role in the price determination of the market.

Keywords

Competitionnursing homespricing
Type
Article
Information
Health Economics, Policy and Law , Volume 16 , Issue 2 , April 2021 , pp. 138 - 153
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

ADASS (2019) ADASS Budget Survey 2019. London: Association of Directors of Adult Social Services.Google Scholar
Akerlof, G (1970) The market for ‘lemons’: quality uncertainty and the market mechanism. Quarterly Journal of Economics 84, 488–500.CrossRefGoogle Scholar
Allan, S and Forder, J (2012) Care Markets in England: Lessons from Research. PSSRU Discussion Paper 2815, Canterbury: PSSRU.Google Scholar
Bartlett, W, Propper, C, Wilson, D and Le Grand, J (1994) Quasi-Markets in the Welfare State. Bristol: SAUS Publications.Google Scholar
Belleflamme, P and Peitz, M (2015) Industrial Organization: Markets and Strategies, 2nd Edn. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Carpenter, JR and Kenward, MG (2013) Multiple Imputation and its Application. Chichester, UK: John Wiley & Sons, Ltd.CrossRefGoogle Scholar
CMA (2017) Care homes market study: Final report. London: Crown Copyright.Google Scholar
Commission on Funding of Care and Support (2011) Fairer Care Funding: The Report of the Commission on Funding of Care and Support, London: Crown Copyright.Google Scholar
County Councils Network and Laing Buisson (2015) County Care Markets: Market Sustainability & the Care Act. London: County Councils Network.Google Scholar
Diamond, P (1971) A model of price adjustment. Journal of Economic Theory 3, 156–168.CrossRefGoogle Scholar
Fernandez, J-L and Snell, T (2012) Survey of Fair Access to Care Services (FACS) Assessment Criteria among Local Authorities in England – Final Report. PSSRU Discussion Paper 2825, London: London School of Economics.Google Scholar
Fernandez, J-L, Snell, T and Wistow, G (2013) Changes in the patterns of social care provision in England: 2005/6 to 2012/13. PSSRU Discussion Paper 2867, London: London School of Economics.Google Scholar
Forder, J (2000) Mental health: market power and governance. Journal of Health Economics 19, 877–905.CrossRefGoogle ScholarPubMed
Forder, J (2007) Self-funded social care for older people: an analysis of eligibility, variations and future projections, PSSRU Discussion Paper 2505. Canterbury: PSSRU.Google Scholar
Forder, J and Allan, S (2011) Competition in the Care Homes Market. Report for the OHE Commission on Competition in the NHS. London: Office of Health Economics.Google Scholar
Forder, J and Allan, S (2014) The impact of competition on quality and prices in the English are homes market. Journal of Health Economics 34, 73–83.CrossRefGoogle ScholarPubMed
Forder, J and Fernandez, J-L (2011), Length of stay in care homes, Report commissioned by Bupa care services, PSSRU Discussion Paper 2769. Canterbury: PSSRU.Google Scholar
Forder, J, Knapp, M and Wistow, G (1996) Competition in the mixed economy of care. Journal of Social Policy 25, 201–221.CrossRefGoogle Scholar
Gaynor, M and Town, R (2011) Competition in Health Care Markets. In Borras, P, McGuire, T and Pauly, M (eds), Handbook of Health Economics, vol 2, Amsterdam: Elsevier. pp. 499–637.Google Scholar
Grabowski, DC (2004) A longitudinal study of Medicaid payment, private-pay price and nursing home quality. International Journal of Health Care Finance and Economics 4, 5–26.CrossRefGoogle ScholarPubMed
Grabowski, DC and Hirth, RA (2003) Competitive spillovers across non-profit and for-profit nursing homes. Journal of Health Economics 22, 1–22.CrossRefGoogle ScholarPubMed
Hancock, R and Hviid, M (2010) Buyer power and price discrimination: the case of the UK care homes market, ISER Working Paper Series 2010-39, Colchester, UK: Institute for Social and Economic Research.Google Scholar
Hancock, R, Malley, J, Wittenberg, R, Morciano, M, Pickard, L, King, D and Comas-Herrera, A (2013) The role of care home fees in the public costs and distributional effects of potential reforms to care home funding for older people in England. Health Economics, Policy and Law 8, 47–73.CrossRefGoogle ScholarPubMed
Humphries, R, Thorlby, R, Holder, H, Hall, P and Charles, A (2016) Social Care for Older People: Home Truths. London: The King's Fund and Nuffield Trust.Google Scholar
Jarrett, T (2019) Adult social care: the Government's ongoing policy review and anticipated Green Paper (England), House of Commons Library Briefing Paper 8002, London: House of Commons.Google Scholar
Kendall, J (2001) Of knights, knaves and merchants: the case of residential care for older people in England in the late 1990s. Social Policy and Administration 35, 360–375.CrossRefGoogle Scholar
Knapp, M, Hardy, B and Forder, J (2001) Commissioning for quality: ten years of social care markets in England. Journal of Social Policy 30, 283–306.CrossRefGoogle Scholar
Laing, W (2008) Calculating the Costs of Efficient Care Homes, Third Edition. Bristol: The Policy Press.Google Scholar
Laing, W (2014) Care of Older People: UK Market Report 2013–14, 26th Edition, London: LaingBuisson.Google Scholar
Malley, J, Trukeschitz, B and Trigg, L (2015) Policy instruments to promote good quality long-term care services. In Fernández, J-L, Gori, C and Wittenberg, R (eds), Long-term Care Reforms in OECD Countries: Successes and Failures. Bristol, UK: Policy Press. pp. 167–194.Google Scholar
Matosevic, T, Knapp, M and Le Grand, J (2008) Motivation and commissioning: perceived and expressed motivations of care home providers. Social Policy and Administration 42, 228–247.CrossRefGoogle Scholar
Mukamel, DB and Spector, WD (2002) The competitive nature of the nursing home industry: price mark ups and demand elasticities. Applied Economics 34, 413–420.CrossRefGoogle Scholar
Mukamel, DB, Spector, WD and Bajorska, A (2005) Nursing home spending patterns in the 1990s: the role of nursing home competition and excess demand. Health Services Research 40, 1040–1055.CrossRefGoogle ScholarPubMed
NatWest (2016) Care Home Benchmarking 2016/2017. London: NatWest.Google Scholar
Needham, C, Burn, E, Hall, K, McKay, S, Mangan, C, Allen, K, Henwood, M, Carr, S and Glasby, J (2018). Shifting Shapes: Report of Work Package 1 – National interviews, local authority survey and secondary data analysis. Birmingham: Health Services Management Centre, University of Birmingham.Google Scholar
Nyman, JA (1989) The private demand for nursing home care. Journal of Health Economics 8, 209–231.CrossRefGoogle ScholarPubMed
Office of Fair Trading (2005) Care Homes for Older People in the UK: A Market Study. London: Office of Fair Trading, Crown Copyright.Google Scholar
Salop, S (1976) Information and monopolistic competition. American Economic Review 66, 240–245.Google Scholar
Salop, S (1977) Noisy monopolist – imperfect information, price dispersion and price-discrimination. Review of Economic Studies 44, 393–406.CrossRefGoogle Scholar
Salop, S and Stiglitz, JE (1977) Bargains and ripoffs: a model of monopolistically competitive price dispersion. Review of Economic Studies 44, 493–510.CrossRefGoogle Scholar
Steventon, A and Roberts, A (2012) Estimating length of stay in publicly-funded residential and nursing care homes: a retrospective analysis using linked administrative data sets. BMC Health Services Research 12, 377.CrossRefGoogle ScholarPubMed
Stiglitz, JE (1979) Equilibrium in product markets with imperfect information. American Economic Review 69, 339–345.Google Scholar
Troyer, JL (2002) Cross-subsidization in nursing homes: explaining rate differentials among payer types. Southern Economic Journal 68, 750–773.CrossRefGoogle Scholar
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