Association between Certificate-of-Need Laws and the Health Outcomes of Home Health Patients

The Certificate of Need (CON) law on home health limits start-ups and expansions by providers. Seventeen states and the District of Columbia maintained CON restrictions in 2015. The regulation was intended to control health care cost and expenditure, and to promote quality public health outcomes, as postulated in the public interest theory. The purpose of the study was to assess the association between the CON laws by the states and the health outcomes of the Medicare patients that used home health services in 2015. The provider ratings data from Home Health Compare were analyzed using multiple linear regression models and t-tests. Findings indicated that the CON significantly contributed to the health outcomes of the patients who used home health services. It was found that the hospitalization rates and the proportion of the patients who used the emergency rooms services were significantly higher in CON states than in the non-CON states. Also, the providers in the CON states had higher improvements on walking, wound healing, breathing, bathing, taking oral medication, pain, and getting in and out of bed. The study adds to the information available to the stakeholders on how the CON affects public health outcomes in the home health sector