Author(s): James Bailey
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Lots has been written here, as you can see from my systematic literature review (attached) and update here link, but many questions are unanswered. Descriptively, what is the average acceptance rate of CON applicants by state? What predicts successful vs unsuccessful CON applications? There’s a lot of variety in what types of facilities and equipment require CON in different state; AHPA lists 28 types of CON restrictions. Many of these types have been the focus of zero papers. In terms of the effects of CON, some big outcomes not addressed since 1998: hospital beds per capita, HHI, profits.
My paper (Bailey, Hamami, McCorry, 2017) on how CON affects prices is more recent but the price data we used was far from ideal, you could probably do much better now. I found (link) that CON states have higher overall Medicare spending, but this is puzzling given that Medicare prices are mostly set nationally, you could use claims data to figure out what drives this (Quantity effects? differential upcoding? Part C?). Outcomes CON may effect that I believe have zero papers: insurance premiums, hospital utilization rates, self-reported health, most types of morbidity, nursing home abuse, hospital openings and closures by local area income. On the identification side, this is one of many literatures full of old papers that could be redone in light of the new literature on staggered adoption and two-way fixed effects.
Published: 2023-01-26 21:49:35 PT
Stage: Research Idea
Fields: Public Economics, Labor Economics
Research Group(s): Playground
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Versions: v1 (01/26/2023)
Anonymous Feb. 2, 2023, 4:02 p.m.
This posting contains multiple research ideas with some ideas based on new question and others on new methods. To be clear for foreigners: "A certificate of need (CON), in the United States, is a legal document required in many states and some federal jurisdictions before proposed acquisitions, expansions, or creations of healthcare facilities are allowed" (Wikipedia). The topic of CONs looks important as some people (John Cochrane among others) believe that CONs significantly restrict the supply of healthcare.