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Factors Associated with the Number of Substance Abuse Nonprofits in the U.S. States: Focusing on Medicaid Expansion, Certificate of Need, and Ownership

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  • Noh Shihyun

    (Department of Public Administration, State University of New York College at Brockport, 55 St Paul StreetRochester, New York, USA)

  • Brown Catherine H.

    (Nebraska Children and Families Foundation, Associate Vice President for Research and Evaluation, Lincoln, Nebraska, USA)

Abstract

The Affordable Care Act improved substance abuse service coverage and increased demand for these services. Presumably, these changes also influenced the number of substance abuse nonprofits in states. State decisions for Medicaid expansion have the potential to influence nonprofits' decisions to establish new facilities, increasing the demand for these services. In addition, Certificate of Need (CON), that is, state regulation of new health services and facilities, can affect nonprofits' responses to increased demand for substance abuse services. This study provides evidence that the number of nonprofit substance abuse facilities is negatively associated with state decisions to expand Medicaid and state regulation of new health services and facilities. However, in states with both Medicaid expansion and CON, the number of nonprofit substance abuse facilities tended to increase. In addition, evidence suggests that both nonprofit and for-profit substance abuse facilities are negatively influenced by Medicaid expansion and CON, but positively influenced by the interaction of Medicaid expansion and CON, government spending, racial diversity, median income, and uninsured rates.

Suggested Citation

  • Noh Shihyun & Brown Catherine H., 2018. "Factors Associated with the Number of Substance Abuse Nonprofits in the U.S. States: Focusing on Medicaid Expansion, Certificate of Need, and Ownership," Nonprofit Policy Forum, De Gruyter, vol. 9(2), pages 1-11, June.
    • Handle: RePEc:bpj:nonpfo:v:9:y:2018:i:2:p:11:n:1
    DOI: 10.1515/npf-2017-0010
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    References listed on IDEAS

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    1. Baker, Matthew C. & Stratmann, Thomas, 2021. "Barriers to entry in the healthcare markets: Winners and Losers from certificate-of-need laws," Socio-Economic Planning Sciences, Elsevier, vol. 77(C).
    2. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2017. "Early Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non‐Expansion States," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(1), pages 178-210, January.
    3. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2016. "Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non-Expansion States," NBER Working Papers 22182, National Bureau of Economic Research, Inc.
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