Certificate of need and the cost of competition in home healthcare markets.

IF 1.2 Q4 HEALTH POLICY & SERVICES

HOME HEALTH CARE SERVICES QUARTERLY Pub Date : 2020-04-01 Epub Date: 2020-02-14 DOI:10.1080/01621424.2020.1728464

Susan L Ettner, Jacqueline S Zinn, Haiyong Xu, Heather Ladd, Eugene Nuccio, Dara H Sorkin, Dana B Mukamel

引用次数: 1

Abstract

We used 2010-16 Medicare Cost Reports for 10,737 freestanding home health agencies (HHAs) to examine the impact of home health (HH) and nursing home (NH) certificate-of-need (CON) laws on HHA caseload, total and per-patient variable costs. After adjusting for other HHA characteristics, total costs were higher in states with only HH CON laws ($2,975,698), only NH CON laws ($1,768,097), and both types of laws ($3,511,277), compared with no CON laws ($1,538,536). Higher costs were driven by caseloads, as CON reduced per-patient costs. Additional research is needed to distinguish whether this is due to skimping on quality vs. economies of scale.

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家庭保健市场的需求证明和竞争成本。

我们使用2010-16年医疗保险成本报告对10,737家独立家庭健康机构(HHAs)进行了研究，以检验家庭健康(HH)和疗养院(NH)需求证明(CON)法律对HHA病例量、总成本和每位患者可变成本的影响。在调整了其他HHA特征后，只有HH CON法(2,975,698美元)、只有NH CON法(1,768,097美元)和两种法律(3,511,277美元)的州的总成本高于没有CON法(1,538,536美元)的州。由于CON降低了每位患者的费用，较高的费用是由病例量驱动的。需要进一步的研究来区分这是由于质量上的吝啬还是规模经济上的吝啬。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

HOME HEALTH CARE SERVICES QUARTERLY HEALTH POLICY & SERVICES-

CiteScore

2.40

自引率

0.00%

发文量

期刊介绍： Home Health Care Services Quarterly continues to publish important research on the cutting edge of home care and alternatives to long-term institutional care for the elderly, disabled, and other population groups that use in-home health care and other community services. The journal is aimed toward service providers and health care specialists involved with health care financing, evaluation of services, organization of services, and public policy issues.