The Effects of Certificate of Need Policies on the Quantity and Quality of Diagnostic Imaging
ResearchPosted on rand.org Jun 25, 2025Published in: Journal of Health Economics, Volume 102 (August 2025), 103020. doi: 10.1016/j.jhealeco.2025.103020
Estimates of the impact of Certificate of Need (CON) laws on medical care have been inconsistent, possibly because not all CON laws apply to all services. Using an original dataset identifying imaging-related CON laws and a regression discontinuity design at state borders, we estimate the effects of CON on the use and quality of diagnostic imaging. Medicare beneficiaries in regulated states are less likely to receive any image and even less likely to receive low-value imaging than beneficiaries in unregulated states. High-value imaging is unaffected. Overall, CON for imaging reduces low-value care and leaves high-value care unchanged.
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