What is a certificate of need (CON)?

A certificate of need (CON) is a legal document that all hospitals and other healthcare providers must submit to their state regulatory agency before making proposed changes to any new or existing facility.

These proposed changes can include any of the following scenarios:

  • Constructing any new healthcare facility
  • Renovating an existing healthcare facility
  • Closing an existing healthcare facility
  • Changing ownership of a healthcare facility
  • Adding a new healthcare service, or removing an existing service, or
  • Acquiring major medical equipment

As of March 2020, a total of 35 states across the U.S. still implement some type of CON law. In states where certificates of need are required for some or all of the above changes, healthcare facilities must submit their certificate for approval before proceeding with any modifications.

The lack of consistent implementation across the U.S. has caused some pushback in states where CON laws are still in place.

Why are certificates of need (CONs) important in healthcare?

Certificates of need are important because they allow state governments to regulate changes that may impact or potentially increase healthcare spending.

The primary goal of these certificates is to ultimately reduce unnecessary healthcare costs by restricting duplicate healthcare services and assessing whether a new facility or service aligns with community need.