There are two sides to every issue -- a pro and a con, each laying out the rationale for thinking a certain way. When debating the issue of granting licenses for new hospitals and services, it's the CON (certificate-of-need) side of the equation that determines the decision.
The certificate-of-need process for the addition of healthcare facilities and services varies widely across the United States. According to a special analyst report by HealthLeaders-InterStudy entitled Pros and CONs: Debating Healthcare Facility Regulation, the debate continues over the CON process and how heavily regulated it should be. Today, 36 states and the District of Columbia require some degree of CON approval for new healthcare facilities and services, covering approximately 65 percent of the nation's population.
"The overall question remains whether or not a government regulatory planning process or the free play of market forces in response to consumer demand does a better job of providing cost-effective and accessible high quality healthcare that is responsive to a particular community's needs," states Patrick Powers, HealthLeaders-InterStudy market analyst.
The most interesting cases reflecting the strength and/or weaknesses of arguments for and against the CON review process are being played out in markets that straddle two or more states, especially states with differing degrees of CON or non-CON regulation. Three such markets are profiled in our special analyst report, including Louisville and Cincinnati markets that include Kentucky, Ohio and Indiana; Washington D.C., Northern Virginia and Baltimore markets that include the District of Columbia, Maryland and Virginia; and the Seattle and Portland markets that include Washington State and Oregon.
Arguments for and against certificate of need laws are wrapped around the basic concepts of cost and access, quality medical treatment, community involvement and provider accountability. A recent study of the effects of CON by Duke University's Center for Health Policy concludes that the evidence is mixed as to whether or not the CON process has significantly contained the overall rise of healthcare costs and saved money or resulted in measurable improvements in healthcare quality and saved lives.
A copy of the special analyst report entitled Pros and CONs: Debating Healthcare Facility Regulation, can be downloaded from our website at http://www.healthleaders-interstudy.com/.
HealthLeaders-InterStudy, a company of Decision Resources, Inc., is the authoritative source for managed care data and analysis.
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