Title

Competitive Spillovers and Regulatory Exploitation by Skilled Nursing Facilities

Document Type

Article

Publication Date

6-2016

Publication Title

Forum for Health Economics & Policy

DOI

10.1515/fhep-2014-0006

Abstract

Typically, research on the effect of ownership has considered health care providers in isolation of competitive interaction from other firms. This analysis considers how the selection of Medicare reimbursement codes for skilled nursing facilities varies by ownership and is influenced by the competitive spillovers from market dominance of for-profit institutions. We find evidence that not-for-profits are less likely to code patients into the highest reimbursement categories. Further, as the market becomes dominated by for-profits, both for-profit and not-for-profits increase the share of patients in these high reimbursement categories.