The Impact of Certificate-of-Need Laws on Nursing Home and Home Health Care Expenditures

被引：28

作者：

Rahman, Momotazur ^{[1
]}

Galarraga, Omar ^{[1
]}

Zinn, Jacqueline S. ^{[2
]}

Grabowski, David C. ^{[3
]}

Mor, Vincent ^{[1
,4
]}

机构：

[1] Brown Univ, Providence, RI 02912 USA

[2] Temple Univ, Philadelphia, PA 19122 USA

[3] Harvard Univ, Sch Med, Boston, MA USA

[4] Providence Vet Adm Med Ctr, Hlth Serv Res Program, Providence, RI USA

来源：

MEDICAL CARE RESEARCH AND REVIEW | 2016年 / 73卷 / 01期

关键词：

certificate of need; Medicare; Medicaid; nursing home care spending; home health care spending; COMMUNITY-BASED SERVICES; LONG-TERM-CARE; PROSPECTIVE PAYMENT SYSTEM; OLDER AMERICANS; EXCESS-DEMAND; MEDICAID HOME; QUALITY; REIMBURSEMENT; PREVALENCE; PREDICTORS;

D O I：

10.1177/1077558715597161

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Over the past two decades, nursing homes and home health care agencies have been influenced by several Medicare and Medicaid policy changes including the adoption of prospective payment for Medicare-paid postacute care and Medicaid-paid long-term home and community-based care reforms. This article examines how spending growth in these sectors was affected by state certificate-of-need (CON) laws, which were designed to limit the growth of providers and have remained unchanged for several decades. Compared with states without CON laws, Medicare and Medicaid spending in states with CON laws grew faster for nursing home care and more slowly for home health care. In particular, we observed the slowest growth in community-based care in states with CON for both the nursing home and home health industries. Thus, controlling for other factors, public postacute and long-term care expenditures in CON states have become dominated by nursing homes.

引用

页码：85 / 105

页数：21

共 45 条

[31] Place of death among older Americans - Does state spending on home- and community-based services promote home death? [J].