The Relationship Between Certificate of Need Laws and Mortality

Jonathan H. Cantor, Jill R. Horwitz, Christopher M. Whaley, Anthony Yu

ResearchPosted on rand.org Nov 21, 2025Published in: National Bureau of Economic Research, Working Paper 34403 (October 2025). DOI: 10.3386/w34403

Certificate of Need (CON) laws regulate entry and capital investments in healthcare with the goal of containing costs while preserving access and quality. This paper examines the relationship between these laws and overall mortality as well as leading causes of mortality: cancer and cardiovascular disease. Using county-level death records, we conducted an event-study analysis comparing mortality rates in states that repealed their CON laws to states that did not between 1979 and 2004. The repeal of CON laws was associated with short-run reductions in cancer mortality, primarily from reductions in lung cancer mortality. Cardiovascular mortality and all-cause mortality rates were unchanged.

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Document Details

  • Copyright: Jonathan H. Cantor, Jill Horwitz, Christopher M. Whaley, Anthony Yu
  • Publisher: National Bureau of Economic Research
  • Availability: Non-RAND
  • Year: 2025
  • Pages: 34
  • Document Number: EP-71156

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