Market structure and provider behavior — Tamara Beetham, PhD, MPH

Industrial-organization frameworks ask how market structure (ownership, consolidation, entry and exit) relates to provider behavior and to the experience of patients. Recent work examines private-equity acquisition of substance use disorder treatment facilities, the relationship between health-system consolidation and Medicare access, and how facility opening and closure mediate the effect of payment reforms.

This thread sits at the intersection of health economics and industrial organization. The empirical questions concern whether changes in ownership and market structure are associated with shifts in access, treatment intensity, retention, and the mix of services offered. The methodological commitment is to designs that can credibly attribute observed changes to ownership or structural events rather than to background trends. Ongoing work in this area examines how organizational structure and ownership in the health-care delivery system relate to access, quality, and equity for the patients those organizations serve.

Representative work

Medicare Appointment Availability and Wait Times Vary Considerably Across Four Large US Urban Markets

Beetham T, Marsh T, Barnett ML, Aaron RM, Greenberg E, Do Alexandra, Zhu JM

Health Affairs Scholar, 4(3), 2026.

Audit evidence that hospital-system-affiliated and multi-site primary care practices were less accessible to new Medicare patients than independent practices.

Private Equity Acquisition and Buprenorphine Prescribing

Holdaway T, Busch SH, Reimer J, Beetham T, Fiellin DA, King M

JAMA Network Open, 9(3):e260250, 2026.

Difference-in-differences study of private-equity acquisition of substance use disorder treatment facilities, finding higher buprenorphine volumes alongside shorter retention.

Medicaid: Increased Patient Access To MOUD In Residential Treatment Associated With Facility Openings And Closures, 2012–22

Beetham T, Newton H, Ndumele C, Fiellin DA, Busch S

Health Affairs, 44(9):1122-1130, 2025.

Quantifying the share of policy-driven access gains that come from facility entry and exit rather than incumbent practice change.

Is access to crisis teams associated with changes in behavioral health mortality?

Newton H, Beetham T, Busch S

Health Affairs Scholar, 3(1):qxaf003, 2025.

Crisis-team entry was associated with reductions in county drug overdose mortality; closures were associated with increases.