EXHIBIT 3.
Adjusted changes in the county-level supply of home health agencies, 2002–17
| Change in average number of agencies per 1,000 beneficiaries per county | |||
|---|---|---|---|
|
|
|||
| Time period | Rural add-on payment | Year-to-year | Cumulative |
| Jun 2002–May 2003 | 10% | —a | (ref) |
| Jun 2003–May 2004 | 0% | 0.12**** | 0.12**** |
| Mar 2004–Feb 2005 | 5% | 0.10**** | 0.22**** |
| Mar 2005–Feb 2006 | 0% | 0.18**** | 0.40**** |
| Jan 2006–Dec 2006 | 5% | 0.27**** | 0.67**** |
| Jan–Dec 2007 | 0% | 0.15**** | 0.82**** |
| Jan–Dec 2008 | 0% | 0.15**** | 0.97**** |
| Jan–Dec 2009 | 0% | 0.00 | 0.97**** |
| Apr 2010–Mar 2011 | 3% | 0.15**** | 1.12**** |
| Jan–Dec 2011 | 3% | −0.11**** | 1.01**** |
| Jan–Dec 2012 | 3% | −0.03 | 0.98**** |
| Jan–Dec 2013 | 3% | 0.09**** | 1.07**** |
| Jan–Dec 2014 | 3% | −0.08*** | 0.99**** |
| Jan–Dec 2015 | 3% | 0.14**** | 1.13**** |
| Jan–Dec 2016 | 3% | −0.05 | 1.08**** |
| Jan–Dec 2017 | 3% | −0.15**** | 0.93**** |
SOURCE Authors’ analysis of data from Home Health Compare and the Geographic Variation Public Use File of the Centers for Medicare and Medicaid Services, and of state certificate-of-need regulations. NOTES The analysis accounts for the correlation across counties over time using random effects specification and adjusts for urban-rural status (urban, urban-adjacent rural, and non-urban-adjacent rural), explained in the notes to exhibit 2; time period; interaction between urban-rural status and time period; state fixed effects; Medicare beneficiary characteristics and utilization at the county level; and state-level regulations on home health agency supply. Significance refers to changes in supply, comparing the current time period to the prior time period for the year-to-year column, and to changes in supply, comparing the current time period to the first time period, for the cumulative column.
Not applicable.
p < 0:01
p < 0:001