State deregulation and Medicare costs for acute cardiac care.
State deregulation and Medicare costs for acute cardiac care.
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DOI：
10.1177/1077558712459681
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发表时间：
2013-04
期刊：
影响因子：
--
通讯作者：
Ku-Goto MH
中科院分区：
文献类型：
--
作者：
Ho V;Ku-Goto MH
Past literature suggests that Certificate of Need (CON) regulations for cardiac care were ineffective in improving quality, but less is known about the effect of CON on patient costs. We analyzed Medicare data for 1991-2002 to test whether states that dropped CON experienced changes in costs or reimbursements for coronary artery bypass graft (CABG) surgery or percutaneous coronary interventions (PCI). We found that states that dropped CON experienced lower costs per patient for CABG, but not for PCI. Average Medicare reimbursement was lower for both procedures in states that dropped CON. The cost savings from removing CON regulations slightly exceed the total fixed costs of new CABG facilities that entered after deregulation. Assuming continued cost savings past 2002, the savings from deregulating CABG surgery outweigh the fixed costs of new entry. Thus, CON regulations for CABG may not be justified in terms of either improving quality or controlling cost growth.
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