{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:55:30Z","timestamp":1791266130622,"version":"4.1.0"},"reference-count":170,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Economics"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>This study reviews the literature on the impacts of Certificate\u2010of\u2010Need (CON) laws on outcomes related to hospitals. CON laws require the approval of states' health planning agencies for health care providers to engage in regulated actions such as opening or expanding facilities or purchasing equipment. Economic theory suggests that barriers to entry should reduce competition, leading to higher prices, greater per\u2010firm quantity but lower market quantity, and larger net revenues for incumbent providers. However, defenders of CON laws argue that they ensure high quality standards for new entrants, while also offsetting distortions that disadvantage hospitals and put some at risk of closure. The preponderance of available evidence points toward CON laws restricting entry of new competitors, which in turn increases the number of procedures per hospital. At the same time, CON laws also appear to inhibit hospital expansion, and there is little evidence of increased prices or higher hospital profitability. Studies on hospital efficiency and quality of care for procedures performed exclusively at hospitals mostly point to null or negative effects, but evidence on quality is more mixed for services that can be provided outside of hospitals. With that said, there is a need for new research that utilizes the latest tools for identifying causal effects and better accounts for the wide variation in CON laws across states.<\/jats:p>","DOI":"10.1002\/hec.70155","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:44:51Z","timestamp":1791265491000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["What Are the Impacts of Certificate\u2010of\u2010Need Laws? A Review of the Evidence"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5422-5350","authenticated-orcid":false,"given":"Charles","family":"Courtemanche","sequence":"first","affiliation":[{"name":"Department of Economics Institute for the Study of Free Enterprise Gatton College of Business and Economics University of Kentucky National Bureau of Economic Research Institute of Labor Economics (IZA)  Lexington Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6475-937X","authenticated-orcid":false,"given":"Joseph","family":"Garuccio","sequence":"additional","affiliation":[{"name":"Institute for the Study of Free Enterprise Gatton College of Business and Economics University of Kentucky  Lexington Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"American Hospital Association.2017.Regulatory Overload: Assessing the Regulatory Burden on Health Systems Hospitals and Post\u2010acute Care Providers.https:\/\/www.aha.org\/system\/files\/2018\u201002\/regulatory\u2010overload\u2010report.pdf."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.2307\/1060194"},{"key":"e_1_2_11_4_1","article-title":"Certificate of Need Regulation of Entry Into Home Health Care","author":"Anderson K. B.","year":"1986","journal-title":"Federal Trade Commission"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.2307\/2109904"},{"issue":"5","key":"e_1_2_11_6_1","first-page":"941","article-title":"Uncertainty and the Welfare Economics of Medical Care","volume":"53","author":"Arrow K. J.","year":"1963","journal-title":"American Economic Review"},{"key":"e_1_2_11_7_1","unstructured":"Ascendient.2019. \u201cCertificate of Need Study: Summary Report.\u201dhttps:\/\/www.kyha.com\/wp\u2010content\/uploads\/2023\/10\/CONStudySummaryReport2019.pdf."},{"issue":"1","key":"e_1_2_11_8_1","first-page":"45","article-title":"The Impact of Hospital Regulatory Programs on per Capita Costs, Utilization, and Capital Investment","volume":"21","author":"Ashby J. L.","year":"1984","journal-title":"Inquiry"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlpt.2019.09.006"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/soej.12693"},{"issue":"20","key":"e_1_2_11_11_1","first-page":"91","article-title":"Does \u201cExcess Supply\u201d Drive Excessive Health Spending? The Case of Certificate\u2010of\u2010Need Laws","volume":"33","author":"Bailey J.","year":"2018","journal-title":"Journal of Private Enterprise"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475\u20106773.12619"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10389\u2010018\u20100998\u20101"},{"issue":"4","key":"e_1_2_11_14_1","article-title":"Certificate of Need Laws and Health Care Prices","volume":"43","author":"Bailey J.","year":"2017","journal-title":"Journal of Health Care Finance"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/coep.12584"},{"issue":"4","key":"e_1_2_11_16_1","first-page":"117","article-title":"Certificate of Need and Inpatient Psychiatric Services","volume":"24","author":"Bailey J.","year":"2021","journal-title":"Journal of Mental Health Policy and Economics"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13011\u2010022\u201000469\u2010z"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seps.2020.101007"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077558706288842"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.2307\/4593126"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.5034\/inquiryjrnl_44.2.200"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2024.09.060"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.01.063"},{"key":"e_1_2_11_24_1","volume-title":"Certificate of Need Regulation in the Nursing Home Industry: Has it Outlived Its Usefulness? (Doctoral Dissertation, University of South Florida)","author":"Caldwell B. J.","year":"2006"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.3368\/jhr.50.2.317"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1215\/03616878\u201018\u20104\u2010905"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11420\u2010019\u201009693\u2010z"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.28.5.1521"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2010.0209"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.11.038"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/jae.3950100107"},{"key":"e_1_2_11_32_1","volume-title":"Conning the Competition: A Nationwide Survey of certificate\u2010of\u2010need Laws","author":"Cavanaugh J.","year":"2020"},{"key":"e_1_2_11_33_1","volume-title":"Striving for Better Care: A Review of Kentucky's Certificate of Need Laws","author":"Cavanaugh R.","year":"2023"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2021.102518"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.3390\/jrfm15020076"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.118.010373"},{"issue":"3","key":"e_1_2_11_37_1","first-page":"1","article-title":"An Analysis of the Effects of Prospective Reimbursement Programs on Hospital Expenditures","volume":"2","author":"Coelen C.","year":"1981","journal-title":"Health Care Financing Review"},{"key":"e_1_2_11_38_1","volume-title":"Certificate of Need: The Cost of the Process","author":"Conley C.","year":"2011"},{"key":"e_1_2_11_39_1","unstructured":"Connecticut Department of Public Health.2015.Certificate of Need Application Process (Regs. Conn. State Agencies \u00a7\u00a7 19a\u2010639a\u20101\u201419a\u2010639a\u20106).https:\/\/eregulations.ct.gov\/eRegsPortal\/Browse\/getDocument%3Fguid=%7B90A1E155\u20100900\u2010CC1E\u2010BEBA\u2010D366FCE5B5A1."},{"key":"e_1_2_11_40_1","unstructured":"Connecticut General Statutes. \u00a7 19a\u2010639a. n.d.Certificate of Need Application Process. Issuance of Decision. Public Hearings. Retention of Independent Consultant. Policies Procedures and Regulations.https:\/\/www.cga.ct.gov\/current\/pub\/chap_368z.htm#sec_19a\u2010639a."},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010020\u201005563\u20101"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1215\/03616878\u201023\u20103\u2010455"},{"key":"e_1_2_11_43_1","volume-title":"Evaluation of Certificate of Need in Michigan. Volume II: Technical Appendices","author":"Conover C. J.","year":"2003"},{"key":"e_1_2_11_44_1","volume-title":"Analyzing the Association of Certificate of Need Regulations on Volume and Quality Indicators for Heart and Kidney Transplantation","author":"Cosby C.","year":"2011"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2010.07.003"},{"issue":"2","key":"e_1_2_11_46_1","first-page":"67","article-title":"The Effects of Prospective Reimbursement Programs on Hospital Adoption and Service Sharing","volume":"4","author":"Cromwell J.","year":"1982","journal-title":"Health Care Financing Review"},{"key":"e_1_2_11_47_1","volume-title":"Report of Data Analyses to the Georgia Commission on the Efficacy of the CON Program (GHPC Report No. 18)","author":"Custer W. S.","year":"2006"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1257\/pol.2.1.51"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.2307\/2667016"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1093\/ectj\/utac017"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1215\/03616878\u20102008\u2010992"},{"issue":"2","key":"e_1_2_11_52_1","first-page":"90","article-title":"The Impact of Certificate of Need Status on the Utilization and Reimbursement of Open and Endoscopic Carpal Tunnel Release","volume":"30","author":"Denduluri S. K.","year":"2021","journal-title":"Journal of Surgical Orthopaedic Advances"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.105.591214"},{"key":"e_1_2_11_54_1","volume-title":"An Evaluation of Illinois\u2019 Certificate of Need Program (Prepared for the Commission on Government Forecasting and Accountability)","author":"Dobson A.","year":"2007"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.2307\/1060045"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.1080\/00036848200000043"},{"issue":"4","key":"e_1_2_11_57_1","first-page":"1","article-title":"Do Hospital Chief Executive Officers Extract Rents From Certificate of Need Laws","volume":"37","author":"Eichmann T. L.","year":"2011","journal-title":"Journal of Health Care Finance"},{"key":"e_1_2_11_58_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621424.2020.1728464"},{"key":"e_1_2_11_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2014.10.033"},{"issue":"5","key":"e_1_2_11_60_1","first-page":"853","article-title":"Hospital Cost Inflation: A Study of Nonprofit Price Dynamics","volume":"61","author":"Feldstein M. S.","year":"1971","journal-title":"American Economic Review"},{"key":"e_1_2_11_61_1","doi-asserted-by":"publisher","DOI":"10.2307\/1913959"},{"key":"e_1_2_11_62_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10729\u2010009\u20109113\u2010z"},{"key":"e_1_2_11_63_1","doi-asserted-by":"publisher","DOI":"10.2307\/1059739"},{"key":"e_1_2_11_64_1","doi-asserted-by":"publisher","DOI":"10.1162\/003465397557088"},{"key":"e_1_2_11_65_1","doi-asserted-by":"publisher","DOI":"10.25011\/cim.v33i2.12345"},{"key":"e_1_2_11_66_1","doi-asserted-by":"publisher","DOI":"10.1177\/10499091231180613"},{"key":"e_1_2_11_67_1","doi-asserted-by":"crossref","DOI":"10.3386\/w1750","volume-title":"A Latent Variable Model of Quality Determination","author":"Gertler P. J.","year":"1985"},{"key":"e_1_2_11_68_1","doi-asserted-by":"publisher","DOI":"10.5034\/inquiryjrnl_40.2.146"},{"key":"e_1_2_11_69_1","doi-asserted-by":"publisher","DOI":"10.1002\/mde.1524"},{"issue":"1","key":"e_1_2_11_70_1","first-page":"93","article-title":"The Effect of Public Policies on Nursing Home Care in the United States","volume":"29","author":"Gulley O. D.","year":"2003","journal-title":"Eastern Economic Journal"},{"issue":"3","key":"e_1_2_11_71_1","first-page":"313","article-title":"The Effect of Certificate of Need and Moratoria Policy on Nursing Home Availability","volume":"32","author":"Harrington C.","year":"1997","journal-title":"Health Services Research"},{"key":"e_1_2_11_72_1","unstructured":"Hawaii State Health Planning and Development Agency.2025.Certificate of Need Application Fee.https:\/\/health.hawaii.gov\/shpda\/files\/2014\/10\/shconfee.doc."},{"issue":"2","key":"e_1_2_11_73_1","first-page":"187","article-title":"The Effect of Certificate\u2010of\u2010Need Legislation on Hospital Investment","volume":"13","author":"Hellinger F. J.","year":"1976","journal-title":"Inquiry"},{"issue":"10","key":"e_1_2_11_74_1","first-page":"737","article-title":"The Effect of Certificate\u2010of\u2010Need Laws on Hospital Beds and Healthcare Expenditures: An Empirical Analysis","volume":"15","author":"Hellinger F. J.","year":"2009","journal-title":"American Journal of Managed Care"},{"key":"e_1_2_11_75_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2020.08.059"},{"key":"e_1_2_11_76_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2003.05.002"},{"key":"e_1_2_11_77_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10754\u2010007\u20109008\u20109"},{"key":"e_1_2_11_78_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077558712459681"},{"key":"e_1_2_11_79_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475\u20106773.2008.00933.x"},{"key":"e_1_2_11_80_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2007.06.031"},{"key":"e_1_2_11_81_1","doi-asserted-by":"crossref","unstructured":"Horwitz J. A.Nichols C.Colla andD.Cutler.2024.Technology Regulation Reconsidered: The Effects of Certificate of Need Policies on the Quantity and Quality of Diagnostic Imaging.https:\/\/doi.org\/10.3386\/w32143.","DOI":"10.3386\/w32143"},{"key":"e_1_2_11_82_1","doi-asserted-by":"publisher","DOI":"10.1162\/ajhe_a_00005"},{"key":"e_1_2_11_83_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2012.02.180"},{"key":"e_1_2_11_84_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2012.08.185"},{"key":"e_1_2_11_85_1","doi-asserted-by":"publisher","DOI":"10.2307\/3003372"},{"key":"e_1_2_11_86_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077558711432889"},{"key":"e_1_2_11_87_1","unstructured":"Kentucky Administrative Regulations: Title 900 6:090 \u00a7 3(4)(a)\u2010(b). n.d.Certificate of Need Filing Hearing and Show Cause Hearings. Legislative Research Commission.https:\/\/apps.legislature.ky.gov\/law\/kar\/titles\/900\/006\/090\/."},{"key":"e_1_2_11_88_1","unstructured":"Kentucky Revised Statutes: \u00a7 216B.085. n.d.Hearing procedures\u2014Notification of Cabinet's decisions\u2014Appeals.https:\/\/apps.legislature.ky.gov\/law\/statutes\/statute.aspx?id=9211."},{"key":"e_1_2_11_89_1","unstructured":"Kentucky Revised Statutes \u00a7 216B.095. n.d.Nonsubstantive Review of Application.https:\/\/apps.legislature.ky.gov\/law\/statutes\/statute.aspx?id=52872."},{"key":"e_1_2_11_90_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2012.08.181"},{"key":"e_1_2_11_91_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urpr.2015.09.001"},{"key":"e_1_2_11_92_1","volume-title":"Permission to Care: An Analysis of certificate\u2010of\u2010need Application Data in Seven States","author":"Kimbrell T.","year":"2024"},{"key":"e_1_2_11_93_1","volume-title":"Essays on Information, Competition, and Quality in Health Care Provider Markets (PhD Dissertation)","author":"Kolstad J. T.","year":"2009"},{"key":"e_1_2_11_94_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010020\u201006518\u20102"},{"key":"e_1_2_11_95_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2025.04.007"},{"key":"e_1_2_11_96_1","doi-asserted-by":"publisher","DOI":"10.1007\/bf00140955"},{"key":"e_1_2_11_97_1","doi-asserted-by":"publisher","DOI":"10.1016\/0277\u20109536(83)90167\u20103"},{"key":"e_1_2_11_98_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.3079"},{"key":"e_1_2_11_99_1","doi-asserted-by":"publisher","DOI":"10.36469\/jheor.2024.121618"},{"key":"e_1_2_11_100_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2011.47"},{"key":"e_1_2_11_101_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2013.31.6_suppl.204"},{"key":"e_1_2_11_102_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.21.4.215"},{"key":"e_1_2_11_103_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2019.05.106"},{"key":"e_1_2_11_104_1","volume-title":"Microeconomic Theory","author":"Mas\u2010Colell A.","year":"1995"},{"key":"e_1_2_11_105_1","doi-asserted-by":"publisher","DOI":"10.2307\/1059572"},{"key":"e_1_2_11_106_1","doi-asserted-by":"publisher","DOI":"10.2307\/1060195"},{"key":"e_1_2_11_107_1","doi-asserted-by":"publisher","DOI":"10.1002\/soej.12686"},{"key":"e_1_2_11_108_1","unstructured":"Metcalf\u2010McCloskey Act of 1964 N.Y. Pub.Health Law \u00a7 730 (Mckinney 1971)."},{"key":"e_1_2_11_109_1","doi-asserted-by":"publisher","DOI":"10.1177\/089826430201400108"},{"key":"e_1_2_11_110_1","doi-asserted-by":"publisher","DOI":"10.3390\/jrfm15010010"},{"key":"e_1_2_11_111_1","doi-asserted-by":"publisher","DOI":"10.1002\/soej.12698"},{"key":"e_1_2_11_112_1","doi-asserted-by":"publisher","DOI":"10.1177\/00469580241251937"},{"key":"e_1_2_11_113_1","article-title":"40 Years of Certificate\u2010of\u2010Need Laws Across America","author":"Mitchell M. D.","year":"2016","journal-title":"Mercatus Center"},{"key":"e_1_2_11_114_1","doi-asserted-by":"publisher","DOI":"10.1177\/2473011425s00437"},{"issue":"1","key":"e_1_2_11_115_1","first-page":"59","article-title":"The Impact of Certificate of Need Laws on Emergency Department Wait Times","volume":"35","author":"Myers M. S.","year":"2020","journal-title":"The Journal of Private Enterprise"},{"key":"e_1_2_11_116_1","doi-asserted-by":"publisher","DOI":"10.1177\/07334648231218079"},{"key":"e_1_2_11_117_1","unstructured":"National Conference of State Legislatures.2024.Certificate of Need State Laws.https:\/\/www.ncsl.org\/health\/certificate\u2010of\u2010need\u2010state\u2010laws."},{"key":"e_1_2_11_118_1","unstructured":"National Health Planning and Resources Development Act of 1974 S.\u00a02994 93rd Cong.1975.https:\/\/www.congress.gov\/bill\/93rd\u2010congress\/senate\u2010bill\/2994."},{"key":"e_1_2_11_119_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2012.07.121"},{"key":"e_1_2_11_120_1","unstructured":"New Jersey Office of the State Auditor.2024.Department of Health Division of Certificate of Need and Licensing: Certificate of Need Program: July 1 2021 to October 31 2023 (Audit Report No. 46010023).https:\/\/pub.njleg.state.nj.us\/publications\/auditor\/2024\/46010023.pdf."},{"key":"e_1_2_11_121_1","doi-asserted-by":"publisher","DOI":"10.1016\/0167\u20106296(88)90028\u20108"},{"key":"e_1_2_11_122_1","doi-asserted-by":"publisher","DOI":"10.1515\/npf\u20102017\u20100010"},{"key":"e_1_2_11_123_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11149\u2010018\u20109351\u20104"},{"key":"e_1_2_11_124_1","unstructured":"Oklahoma Administrative Code: \u00a7 310:4\u20101\u20108. n.d.Reconsideration of Decision.https:\/\/rules.ok.gov\/code."},{"key":"e_1_2_11_125_1","article-title":"CON Regulations Should Not be Used to Close Whole Units of Hospital Services","author":"Pattee C.","year":"2024","journal-title":"CT Mirror"},{"key":"e_1_2_11_126_1","unstructured":"Pennsylvania Statutes: Health Care Facilities Act: 35 P.S. \u00a7 448.904a. n.d.Sunset. Pennsylvania General Assembly.https:\/\/www.legis.state.pa.us\/WU01\/LI\/LI\/US\/HTM\/1979\/0\/0048..HTM."},{"key":"e_1_2_11_127_1","doi-asserted-by":"publisher","DOI":"10.1287\/serv.2018.0228"},{"key":"e_1_2_11_128_1","doi-asserted-by":"publisher","DOI":"10.1017\/s1744133117000184"},{"key":"e_1_2_11_129_1","doi-asserted-by":"publisher","DOI":"10.2139\/ssrn.3225741"},{"key":"e_1_2_11_130_1","doi-asserted-by":"publisher","DOI":"10.1002\/soej.12696"},{"key":"e_1_2_11_131_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.1646"},{"key":"e_1_2_11_132_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpubeco.2013.11.003"},{"key":"e_1_2_11_133_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.18.2141"},{"key":"e_1_2_11_134_1","unstructured":"Public Law No. 99\u2010660. n.d.\u00a7 701 100 Stat. 3743 3799."},{"key":"e_1_2_11_135_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077558715597161"},{"issue":"4","key":"e_1_2_11_136_1","first-page":"1","article-title":"The Effects of Certificate of Need Regulation on Hospital Costs","volume":"36","author":"Rivers P. A.","year":"2010","journal-title":"Journal of Health Care Finance"},{"key":"e_1_2_11_137_1","doi-asserted-by":"publisher","DOI":"10.1177\/0017896907080127"},{"key":"e_1_2_11_138_1","doi-asserted-by":"publisher","DOI":"10.1016\/0167\u20106296(85)90012\u20108"},{"key":"e_1_2_11_139_1","doi-asserted-by":"publisher","DOI":"10.1177\/106286060101600502"},{"key":"e_1_2_11_140_1","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.106.658377"},{"key":"e_1_2_11_141_1","doi-asserted-by":"publisher","DOI":"10.2307\/3349587"},{"key":"e_1_2_11_142_1","volume-title":"Hospital certificate\u2010of\u2010need Controls: Impact on Investment, Costs, and Use","author":"Salkever D. S.","year":"1979"},{"key":"e_1_2_11_143_1","doi-asserted-by":"publisher","DOI":"10.1097\/jhq.0000000000000286"},{"key":"e_1_2_11_144_1","doi-asserted-by":"publisher","DOI":"10.1002\/soej.12689"},{"key":"e_1_2_11_145_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2025.09.3051"},{"key":"e_1_2_11_146_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010008\u20109914\u20101"},{"key":"e_1_2_11_147_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejm198804283181705"},{"key":"e_1_2_11_148_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2010.09.016"},{"key":"e_1_2_11_149_1","doi-asserted-by":"publisher","DOI":"10.2307\/1935842"},{"key":"e_1_2_11_150_1","doi-asserted-by":"publisher","DOI":"10.2307\/3349905"},{"key":"e_1_2_11_151_1","doi-asserted-by":"publisher","DOI":"10.1086\/466953"},{"key":"e_1_2_11_152_1","unstructured":"Social Security Amendments of 1983 Pub. L.\u00a0No. 98 21 97 Stat. 65.1983.https:\/\/www.govinfo.gov\/content\/pkg\/STATUTE\u201097\/pdf\/STATUTE\u201097\u2010Pg65.pdf."},{"key":"e_1_2_11_153_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2020.08.201"},{"key":"e_1_2_11_154_1","doi-asserted-by":"publisher","DOI":"10.3390\/jrfm15060272"},{"key":"e_1_2_11_155_1","doi-asserted-by":"publisher","DOI":"10.2139\/ssrn.3667311"},{"key":"e_1_2_11_156_1","doi-asserted-by":"publisher","DOI":"10.1002\/soej.12710"},{"key":"e_1_2_11_157_1","article-title":"Entry Regulation and Rural Health Care: Certificate\u2010of\u2010Need Laws, Ambulatory Surgical Centers, and Community Hospitals (MERCATUS Working Paper)","author":"Stratmann T.","year":"2016","journal-title":"SSRN"},{"key":"e_1_2_11_158_1","volume-title":"Do certificate\u2010of\u2010need Laws Increase Indigent Care?","author":"Stratmann T.","year":"2014"},{"key":"e_1_2_11_159_1","doi-asserted-by":"publisher","DOI":"10.1300\/j045v02n02_06"},{"key":"e_1_2_11_160_1","unstructured":"U. S.\u00a0Census Bureau. n.d.Rural America.https:\/\/mtgis\u2010portal.geo.census.gov\/arcgis\/apps\/storymaps\/collections\/189aa1dbd64c4c81b3b4a2b71124f6c6?item=1."},{"key":"e_1_2_11_161_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.15.1859"},{"key":"e_1_2_11_162_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077558709346565"},{"key":"e_1_2_11_163_1","doi-asserted-by":"publisher","DOI":"10.1093\/geroni\/igaf122.282"},{"key":"e_1_2_11_164_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2024.07.043"},{"key":"e_1_2_11_165_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2024.05.051"},{"key":"e_1_2_11_166_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.artd.2025.101670"},{"key":"e_1_2_11_167_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2011.07.012"},{"key":"e_1_2_11_168_1","doi-asserted-by":"publisher","DOI":"10.1177\/00469580241277444"},{"key":"e_1_2_11_169_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.21115"},{"key":"e_1_2_11_170_1","doi-asserted-by":"publisher","DOI":"10.1097\/bsd.0000000000000914"},{"key":"e_1_2_11_171_1","doi-asserted-by":"publisher","DOI":"10.1097\/bco.0000000000000828"}],"container-title":["Health Economics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hec.70155","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hec.70155","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hec.70155","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:45:05Z","timestamp":1791265505000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hec.70155"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":170,"alternative-id":["10.1002\/hec.70155"],"URL":"https:\/\/doi.org\/10.1002\/hec.70155","archive":["Portico"],"relation":{},"ISSN":["1057-9230","1099-1050"],"issn-type":[{"value":"1057-9230","type":"print"},{"value":"1099-1050","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,5]]},"assertion":[{"value":"2025-09-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"hec.70155"}}