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

Health Econ. 2019 Apr;28(4):492-516. doi: 10.1002/hec.3859. Epub 2019 Jan 28.

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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Certificate of Need / statistics & numerical data*
  • Economic Competition / statistics & numerical data*
  • Home Care Services / statistics & numerical data*
  • Humans
  • Medicare / statistics & numerical data
  • Quality Indicators, Health Care
  • Quality of Health Care / statistics & numerical data*
  • United States