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Competitive effects of scope of practice restrictions: Public health or public harm?

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  • Markowitz, Sara
  • Adams, E. Kathleen
  • Lewitt, Mary Jane
  • Dunlop, Anne L.

Abstract

The demand for healthcare professionals is predicted to grow significantly over the next decade. Securing an adequate workforce is of primary importance to ensure the health and wellbeing of the population in an efficient manner. Occupational licensing laws and related restrictions on scope of practice (SOP) are features of the market for healthcare professionals and are also controversial. At issue is a balance between protecting the public health and removing anticompetitive barriers to entry and practice. In this paper, we examine the case of SOP restrictions for certified nurse midwives (CNMs) and evaluate the effects of changes in states’ SOP laws on markets for CNMs and on maternal and infant outcomes. We find that SOP laws are neither helpful nor harmful in regards to health outcomes but states that have no SOP-based barriers have lower rates of induced labor and Cesarean section births. We discuss the implications for state policy.

Suggested Citation

  • Markowitz, Sara & Adams, E. Kathleen & Lewitt, Mary Jane & Dunlop, Anne L., 2017. "Competitive effects of scope of practice restrictions: Public health or public harm?," Journal of Health Economics, Elsevier, vol. 55(C), pages 201-218.
    • Handle: RePEc:eee:jhecon:v:55:y:2017:i:c:p:201-218
    DOI: 10.1016/j.jhealeco.2017.07.004
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    Cited by:

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    2. Apergis, Nicholas & Chasiotis, Ioannis & Georgantopoulos, Andreas G. & Konstantios, Dimitrios, 2021. "The integration of share repurchases into investment decision-making: Evidence from Japan," International Review of Financial Analysis, Elsevier, vol. 78(C).
    3. Dick M. Carpenter & Lisa Knepper & Kyle Sweetland & Jennifer McDonald, 2018. "The Continuing Burden of Occupational Licensing in the United States," Economic Affairs, Wiley Blackwell, vol. 38(3), pages 380-405, October.
    4. Tianyuan Luo & Cesar L. Escalante & Carmina E. Taylor, 2021. "Labor market outcomes of granting full professional independence to nurse practitioners," Journal of Regulatory Economics, Springer, vol. 60(1), pages 22-54, August.
    5. Roy Choudhury, Agnitra & Plemmons, Alicia, 2023. "Effects of giving psychologists prescriptive authority: Evidence from a natural experiment in the United States," Health Policy, Elsevier, vol. 134(C).
    6. Shishir Shakya & Alicia Plemmons, 2020. "Does Scope of Practice Affect Mobility of Nurse Practitioners Serving Medicare Beneficiaries?," Journal of Labor Research, Springer, vol. 41(4), pages 421-434, December.
    7. Laura Barrie Smith, 2022. "The effect of nurse practitioner scope of practice laws on primary care delivery," Health Economics, John Wiley & Sons, Ltd., vol. 31(1), pages 21-41, January.
    8. Pinka Chatterji & Chun-Yu Ho & Xue Wu, 2023. "Obstetric Unit Closures and Racial/Ethnic Disparity in Health," NBER Working Papers 30986, National Bureau of Economic Research, Inc.
    9. Chen, Alice J. & Munnich, Elizabeth L. & Parente, Stephen T. & Richards, Michael R., 2023. "Provider turf wars and Medicare payment rules," Journal of Public Economics, Elsevier, vol. 218(C).
    10. Xia, Xing, 2021. "Barrier to Entry or Signal of Quality? The Effects of Occupational Licensing on Minority Dental Assistants," Labour Economics, Elsevier, vol. 71(C).

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    More about this item

    Keywords

    Scope of Practice; Infant health; Maternal health; Occupational licensing; Certified nurse midwife;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • J44 - Labor and Demographic Economics - - Particular Labor Markets - - - Professional Labor Markets and Occupations
    • K2 - Law and Economics - - Regulation and Business Law

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