Susan L Ettner, Jacqueline S Zinn, Haiyong Xu, Heather Ladd, Eugene Nuccio, Dara H Sorkin, Dana B Mukamel
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Certificate of need and the cost of competition in home healthcare markets.
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.
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.