The Impact of Repealing Certificate‐of‐Need Laws on Healthcare Spending: A Causal Analysis

Certificate-of-Need laws in 35 US states require healthcare providers to obtain government approval before building new facilities or expanding services. Their stated goal is to ensure a genuine community need and avoid redundant services, with the aim of controlling healthcare costs and distributing resources fairly, although their effectiveness is debated. Our study differs from previous literature as we present the causal effects of repealing Certificate-of-Need laws on various healthcare expenses using modern difference-in-differences techniques and event studies. Our findings suggest that repealing Certificate-of-Need laws can reduce the burden of healthcare spending.

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Publication Details

Journal
Health Economics
Published
2026-10-14
DOI
https://doi.org/10.1002/hec.70160
Primary Topic
Healthcare Policy and Management
Type
article
Field-Weighted Citation Impact
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article

The Impact of Repealing Certificate‐of‐Need Laws on Healthcare Spending: A Causal Analysis

Shishir Shakya
Health Economics
Healthcare Policy and Management
article

The Impact of Repealing Certificate‐of‐Need Laws on Healthcare Spending: A Causal Analysis

Shishir Shakya
article en

Abstract

Certificate-of-Need laws in 35 US states require healthcare providers to obtain government approval before building new facilities or expanding services. Their stated goal is to ensure a genuine community need and avoid redundant services, with the aim of controlling healthcare costs and distributing resources fairly, although their effectiveness is debated. Our study differs from previous literature as we present the causal effects of repealing Certificate-of-Need laws on various healthcare expenses using modern difference-in-differences techniques and event studies. Our findings suggest that repealing Certificate-of-Need laws can reduce the burden of healthcare spending.

Health Economics
West Virginia University (US), Appalachian State University (US)
Peace, justice, and strong institutions
Openalex Percentile: Top 100%
Healthcare Policy and Management
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