The Effects of Health Insurance Consolidation: Evidence from a Large Merger in Brazil

• Grant number: 25/01329-3
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate (Direct)
• Start date: September 01, 2025
• End date: May 31, 2026
• Field of knowledge: Applied Social Sciences - Economics - Industrial Economics
• Principal Investigator: Letícia Faria de Carvalho Nunes
• Grantee: Heitor Alves de Oliveira Lima
• Supervisor: Cristobal Otero
• Host Institution: Instituto de Ensino e Pesquisa (Insper). São Paulo , SP, Brazil
• Institution abroad: Columbia Business School, United States
• Associated to the scholarship: 24/03933-2 - Competition Effects of Government Subsidizing: Evidence from a Drug Access Program, BP.DD

Abstract

Mergers in the healthcare industry have been widely studied in the literature, but mainly in the context of developed countries, and dealing with purely horizontal or vertical mergers. This project aims to fill this gap by studying a merger between two large Brazilian health insurance companies, Hapvida and NotreDame Intermédica, which implies both a horizontal and a vertical merger, since NotreDame already managed itsown hospitals. We propose a difference-in-differences approach to examine the merger effects at the market level leveraging geographical heterogeneity in exposure to the merger. We aim to estimate the effects of the merger on the composition of provider network and enrollee profile. The research will shed light on insurer merger effects in a developing country, which is also the second largest private healthcare market in the world.