Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Apr;28(4):492-516.
doi: 10.1002/hec.3859. Epub 2019 Jan 28.

Entry regulation and the effect of public reporting: Evidence from Home Health Compare

Bingxiao Wu  1 , Jeah Jung  2 , Hyunjee Kim  3 , Daniel Polsky  4
Affiliations

Entry regulation and the effect of public reporting: Evidence from Home Health Compare

Bingxiao Wu et al. Health Econ. 2019 Apr.

Abstract

Economic theory suggests that competition and information are complementary tools for promoting health care quality. The existing empirical literature has documented this effect only in the context of competition among existing firms. Extending this literature, we examine competition driven by the entry of new firms into the home health care industry. In particular, we use the certificate of need (CON) law as a proxy for the entry of firms to avoid potential endogeneity of entry. We find that home health agencies in non-CON states improved quality under public reporting significantly more than agencies in CON states. Because home health care is a labor-intensive and capital-light industry, the state CON law is a major barrier for new firms to enter. Our findings suggest that policymakers may jointly consider information disclosure and entry regulation to achieve better quality in home health care.

Keywords: certificate of need; competition; home health care quality; information disclosure.

PubMed Disclaimer

Figures

Figure A1:
Figure A1:
A Sample of Home Health Compare—Table Display Note: The comparison table is displayed after a consumer visiting the HHC website types in a ZIP/city/state. Consumers can choose quality measures of interest and select up to three HHAs for comparison at a time.
Figure A2:
Figure A2:
A Sample of Home Health Compare—Graphical Display Note: The comparison graph is displayed after a consumer visiting the HHC website types in a ZIP/city/state. Consumers can choose quality measures of interest and select up to three HHAs for comparison at a time.
Figure A2.a:
Figure A2.a:
Distribution of percentage change in the state-level number of agencies in CON and non-CON states between 2001 and 2006
Figure A2.b:
Figure A2.b:
Distribution of percentage change in average zip code-level HHI in CON and non-CON states between 2001 and 2006
Figure A3:
Figure A3:
Reported Functional Improvement by CON status, 2001–2006
Figure A4:
Figure A4:
Unreported Functional Improvement by CON status, 2001–2006
Figure A5:
Figure A5:
Hospitalization Rate by CON status, 2001–2006
Figure A6:
Figure A6:
Emergency Department Visit Rate by CON status, 2001–2006
Figure 1:
Figure 1:
Total Number of agencies in CON states and non-CON states over time.
See this image and copyright information in PMC

References

    1. Carter A, 2009. Nursing shortage predicted to be hardest on home healthcare. Home Healthcare Now 27, 198 - PubMed
    1. Chassin MR, 2002. Achieving and sustaining improved quality: lessons from New York State and cardiac surgery. Health Affairs 21, 40–51 - PubMed
    1. Chou S-Y, Deily ME, Li S, Lu Y, 2014. Competition and the impact of online hospital report cards. Journal of Health Economics 34, 42–58 - PubMed
    1. Conover CJ, Sloan FA, 1998. Does removing Certificate-of-Need regulations lead to a surge in health care spending? Journal of Health Politics, Policy and Law 23, 455–481 - PubMed
    1. Cutler DM, Huckman RS, Kolstad JT, 2010. Input constraints and the efficiency of entry: Lessons from cardiac surgery. American Economic Journal: Economic Policy 2, 51–76

Publication types

MeSH terms