Public vs. private provision of charity care? Evidence from the expiration of Hill-Burton requirements in Florida

B-Tier
Journal: Journal of Health Economics
Year: 2011
Volume: 30
Issue: 1
Pages: 189-199

Score contribution per author:

0.670 = (α=2.01 / 3 authors) × 1.0x B-tier

α: calibrated so average coauthorship-adjusted count equals average raw count

Abstract

This paper explores the consequences of the expiration of charity care requirements imposed on private hospitals by the Hill-Burton Act. We examine delivery care and the health of newborns using the universe of Florida births from 1989 to 2003 combined with hospital data from the American Hospital Association. We find that charity care requirements were binding on hospitals, but that private hospitals under obligation "cream skimmed" the least risky maternity patients. Conditional on patient characteristics, they provided less intensive maternity services but without compromising patient health. When obligations expired, private hospitals quickly reduced their charity caseloads, shifting maternity patients to public hospitals. The results in this paper suggest, perhaps surprisingly, that requiring private providers to serve the underinsured can be effective.

Technical Details

RePEc Handle
repec:eee:jhecon:v:30:y:2011:i:1:p:189-199
Journal Field
Health
Author Count
3
Added to Database
2026-01-24