Past studies of hospital rate setting regulation conclude that mature programs have been effective in constraining hospital expenditures. However, if rate regulation is influenced by higher hospital expenditures the relationship between expenditures and rate setting is confounded. This study assesses the impact of rate setting on hospital and non-hospital expenditures using a simultaneous-equation model which separates the effects of hospital expenditures on the decision to regulate from the effects of regulation on expenditures. The simultaneous-equation results indicate that mature rate setting is associated with lower per capita health care expenditures, including hospital and non-hospital expenditures.
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Antel, John J., Edmund R. Becker, and Robert L. Ohsfeldt. 1989. “State Regulation and Hospital Costs: A Simultaneous Equations Approach.” Presented at the ASSA meetings, Atlanta (December).
Baltagi, Badi H. 1984. “A Monte Carlo Study for Pooling Time-Series of Cross-Section Data in the Simultaneous Equations Model.” International Economic Review 25 (October): 603–624.
Barzel, Yoram. 1976. “An Alternative Approach to the Analysis of Taxation.” Journal of Political Economy (December): pp1177-1198.
Becker, Gary S. 1983. “A Theory of Competition among Interest Groups for Political Influence.” Quarterly Journal of Economics 98 (August): 371–400.
Coelen, Craig, and Daniel Sullivan. 1981. “An Analysis of the Effects of Prospective Reimbursement Programs on Hospital Expenditures.” Health Care Financing Review 2 (Winter): 1–40.
Cone, Kenneth R., and David Dranove. 1986. “Why Did States Enact Hospital Rate-Setting Laws? Journal of Law and Economics 29 (October): 287–302.
Danzon, Patricia M. 1985. “Hospital ‘Profits’: The Effects of Reimbursement Policies.” Journal of Health Economics 1 (March): 29–52.
Dranove, David, and Kenneth R. Cone. 1985. “Do Rate Setting Laws Really Lower Hospital Expenses? Journal of Health Economics 4 (June): 159–168.
Eby, Charles L., and Donald R. Cohodes. 1985. “What Do We Know about Rate-Setting? Journal of Health Politics, Policy and Law 10 (Summer): 299–328.
Edwards, Linda. N. 1978. “An Empirical Analysis of Compulsory Schooling Legislation, 1940–1960.” Journal of Law and Economics 21 (April): 203–222.
Fanara, Philip, and Warren Greenberg. 1985. Factors Affecting the Adoption of Prospective Reimbursement Programs by State Governments. In Incentives vs. Controls in Health Policy, edited by Jack A. Meyer. Washington, DC: American Enterprise Institute, pp. 144–56.
Gaumer, G.L., E.L. Poggio, C.G. Coelen, et al. 1989. “Effects of State Prospective Payment Systems on Hospital Mortality.” Medical Care 27 (July): 724–36.
Heckman, James J. 1978. “Dummy Endogenous Variables in A Simultaneous Equation System.” Econometrica 46 (July): 931–959.
Hsiao, Cheng. 1986. Analysis of Panel Data. Cambridge, MA: Cambridge University Press.
Joskow, Paul L. 1981. Controlling Hospital Costs: The Role of Government Regulation. Cambridge, MA: The MIT Press.
Joskow, Paul L. 1980. “Effects of Competition and Regulation on Hospital Bed Supply and Reservation Quality of the Hospital.” Bell Journal of Economics 11 (Autumn): 421–47.
Kennedy, Peter 1981. “Estimation with Correctly Interpreted Dummy Variables in Semilogarithmic Equations.” American Economic Review 71 (September): 801.
Kmenta, Jan. 1986. Elements of Econometrics, 2nd ed. New York: Macmillan.
Lanning, Joyce A. 1988. The Impact of Hospital Rate Setting on Health Expenditures, unpublished Ph.D. thesis, University of Alabama at Birmingham.
Leffler, Keith B. 1982. “Ambiguous Changes in Product Quality.” American Economic Review 72 (December): 956–67.
Levit, Katherine R. 1985. “Personal Health Care Expenditures, by State.” Health Care Financing Review 6 (Summer): 1–49.
Maddala, G. S. 1977. Econometrics. New York: McGraw-Hill.
Maddala G. S. 1983. Limited-Dependent and Qualitative Variables in Econometrics. Cambridge, MA: Cambridge University Press.
Maddala, G. S. 1988. Introduction to Econometrics. New York: Macmillan.
Morrisey, Michael. A., Douglas A. Conrad, Stephen. M. Shortell, and Karen S. Cook. 1984. “Hospital Rate Review: A Theory and an Empirical Review.” Journal of Health Economics 3 (September): 25–47.
Morrisey, Michael. A., Frank. A. Sloan, and Samuel A. Mitchell. 1983. “State Rate Setting: An Analysis of Some Unresolved Issues.” Health Affairs 2 (Summer): 36–47.
Peltzman, Sam 1976. “Toward A More General Theory of Regulation.” Journal of Law and Economics 19 (August): 211–240.
Shortell, Stephen M., and Edward Hughes. 1988. “The Effects of Regulation, Competition, and Ownership on Mortality Rates Among Hospital Inpatients.” New England Journal of Medicine 318 (April 28): 1100–1107.
Sloan, Frank A. 1983. “Rate Regulation as a Strategy for Hospital Cost Control: Evidence from the Last Decade.” Milbank Memorial Fund Quarterly 61 (Spring): 195–221.
Sloan, Frank A. 1988. Containing Health Expenditures: Lessons Learned from Certificate-of-Need Programs. In Cost, Quality, and Access in Health Care: New Roles for Health Planning in a Competitive Environment, edited by Frank A. Sloan, et al. San Francisco: Jossey-Bass Publishers, Chapter 3.
Sloan, Frank A., and Bruce Steinwald. 1980. “Effects of Regulation on Hospital Costs and Input Use.” Journal of Law and Economics 23 (April): 81–109.
Sloan, Frank A., Michael A. Morrisey, and Joseph Valvona. 1988. “Effects of the Medicare Prospective Payment System on Hospital Cost Containment: An Early Appraisal.” Milbank Quarterly 66(2): 191–220.
Stigler, George T. 1971. “The Theory of Economic Regulation.” Bell Journal of Economics and Management Science 2 (Spring): 3–21.
Thorpe, Kenneth E., and Charles E. Phelps. 1990. “Regulatory Intensity and Hospital Cost Growth.” Journal of Health Economics 9 (September): 143–166.
Urban, N., and T. W. Bice. 1981. Measuring Regulation and Its Effects on Hospital Behavior. Working Paper. Seattle, WA: Department of Health Services, University of Washington.
Wendling, Wayne, and Jack L. Werner. 1980. “Nonprofit Firms and the Economic Theory of Regulation.” Quarterly Review of Economics and Business 20 (Autumn): 7–18.
Zwanziger, Jack, and Glenn A. Melnick. 1988. “The Effects of Hospital Competition and the Medicare PPS Program on Hospital Cost Behavior in California.” Journal of Health Economics 7 (December): 301–320.
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Lanning, J.A., Morrisey, M.A. & Ohsfeldt, R.L. Endogenous hospital regulation and its effects on hospital and non-hospital expenditures. J Regul Econ 3, 137–154 (1991). https://doi.org/10.1007/BF00140955
- Health Care
- Public Finance
- Past Study
- Industrial Organization
- Rate Setting