Technology Regulation Reconsidered: The Effects of Certificate of Need Policies on the Quantity and Quality of Diagnostic Imaging

Estimates of the impact of Certificate of Need laws on medical care have been inconsistent, possibly because not all CON laws apply to all services. Using an original dataset identifying imaging-related CON laws, we estimate the effects of CON on CT and MRI, using regression discontinuities at state borders. Medicare beneficiaries in regulated states are slightly less likely to receive any image and considerably less likely to receive low-value imaging than beneficiaries in non-regulated states. High-value imaging is either unaffected or declines much less. Overall, CON reduces low value care and largely leaves high value care unaffected.