An Economic Investigation of Regulations and Financial Challenges Facing Hospitals

This four-year award will be used to develop a comprehensive, multifaceted research and dissemination program centered around many speci?c questions that relate to these overarching issues facing hospitals: 1) How do site-neutral payments a?ect hospital operations and services? 2) How does removing certi?cate-of-need laws impact hospital operations and services? 3) What are the main types of regulations that hospitals face and how do they impact health care costs? 4) How does tort reform impact health care costs and access to care (e.g. for obstetrics)? 5) What are the causes of and potential solutions (e.g. new technologies, recruiting health care workers from abroad) for the health care workforce shortage? 6) How does the administrative burden on hospitals from insurers contribute to rising costs and delays in patients getting care? 7) How would greater investment in health care in the Appalachian region change health outcomes and workforce participation? 8) How has workforce violence in?uenced the health care workforce and what laws might be changed to improve safety? The ?rst step of the research process is to understand the existing body of knowledge on the topic at hand. Therefore, we will begin by producing a literature review paper on each topic that articulates the issues, summarizes and evaluates the existing evidence on the topic, assesses what conclusions can be drawn based on the evidence thus far, and discusses what important questions remain to be de?nitively answered. After completing this extensive background research, we will understand where the gaps are in the relevant academic literatures and which topics would bene?t the most from original investigations involving our own data collection and analysis. In the next phase of the project, we will write and disseminate two such original research articles. The ?nal phase of the project will be a sub-award grants program that enables us to leverage other scholars’ time and unique expertise to study more and a broader range of topics than we otherwise could. The program will make three awards to UK PhD students and another three to faculty at other universities. Awardees will share their preliminary results with and obtain feedback from the group in a virtual progress report conference. Upon completion of the projects, I will publish a symposium (partial special issue) in the Southern Economic Journal (where I am the lead editor) to feature papers that rise to the journal’s editorial standards.