The causal effect of repealing Certificate‐of‐Need laws for ambulatory surgical centers: Does access to medical services increase?

Author:

Stratmann Thomas1,Bjoerkheim Markus2,Koopman Christopher3

Affiliation:

1. Department of Economics George Mason University Fairfax Virginia USA

2. Mercatus Center George Mason University Fairfax Virginia USA

3. The Center for Growth and Opportunity Utah State University Logan Utah USA

Abstract

AbstractIn many states, Certificate‐of‐Need (CON) laws prevent ambulatory surgical centers (ASCs) from entering the market or expanding their services. This paper estimates the causal effects of state ASC‐CON law repeal on the accessibility of medical services statewide, as well as for rural areas. Our findings show that CON law repeals increase ASCs per capita by 44%–47% statewide and 92%–112% in rural areas. Repealing ASC‐CON laws causes a continuous increase in ASCs per capita, an effect which levels off 10 years after repeal. Contrary to the “cream‐skimming” hypothesis, we find no evidence that CON repeal is associated with hospital closures in rural areas. Rather, some regression models show that repeal is associated with fewer medical service reductions.

Publisher

Wiley

Reference51 articles.

1. The Effect of Certificate of Need Laws on All-Cause Mortality

2. Barriers to entry in the healthcare markets: winners and losers from certificate‐of‐need laws;Baker M.C.;Socio‐Economic Planning Sciences,2021

3. Borusyak K. Jaravel X.&Spiess J.(2021)Revisiting event study designs: Robust and efficient estimation.arXiv preprint arXiv:2108.12419.

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