Healthcare Insights

Healthcare facility construction activity by state

Hospital and healthcare construction projects expand and improve facilities to better serve patients and the healthcare providers who work there. And new healthcare facilities help increase services and capabilities in the local communities.

How is healthcare construction activity tracked?

In the Definitive Healthcare HospitalView product, we collect Certificates of Need (CONs) and Requests for Proposals (RFPs) from federal, state, local and healthcare system websites. The “new hospitals/units/services” and “hospital/facility relocation/renovation” CON categories and “construction - new building/relocation/design” RFP category track new hospital buildings, hospital construction projects and healthcare facility renovations to inform the market on planned projects.

Which states have the most healthcare construction activity?

Between 2018 and February 2022, we collected over 11,500 healthcare construction CONs and RFPs. This list below ranks states by their total number of construction related CONs and RFPs over the last few years.

Number of healthcare construction CONs and RFPs by state

RankStateNumber of CONs and RFPs 2018-2020Explore dataset
1New York2,420Explore
2Texas674Explore
3Georgia589Explore
4California578Explore
5North Carolina446Explore
6Florida433Explore
7Virginia414Explore
8Michigan370Explore
9South Carolina631Explore
10Washington341Explore
11Illinois340Explore
12Pennsylvania295Explore
13Massachusetts263Explore
14Maryland263Explore
15Kentucky256Explore
16Ohio256Explore
17Alabama222Explore
18District of Columbia217Explore
19Missouri179Explore
20Tennessee178Explore
21Louisiana145Explore
22West Virginia133Explore
23Mississippi133Explore
24Wisconsin130Explore
25Colorado118Explore
26Connecticut117Explore
27Iowa115Explore
28Arkansas112Explore
29Oklahoma103Explore
30Hawaii101Explore
31New Jersey101Explore
32Kansas94Explore
33Indiana91Explore
34Utah84Explore
35Arizona83Explore
36Rhode Island81Explore
37Nevada76Explore
38Alaska67Explore
39Minnesota66Explore
40Maine63Explore
41Oregon54Explore
42Montana52Explore
43Delaware49Explore
44New Mexico48Explore
45South Dakota44Explore
46Wyoming40Explore
47Vermont38Explore
48Nebraska36Explore
49Idaho33Explore
50New Hampshire23Explore
51North Dakota23Explore

Fig. 1 Data is from the Definitive Healthcare HospitalView product. News and intelligence data is proprietary and updated daily. Data accessed March 2022.

New York had the most construction CONs and RFPs from 2018 through February 2022 with over 2,400. The state’s large population and number of healthcare facilities likely contribute to this number. Texas had nearly 700 CONs and RFPs while Georgia had almost 600.

What is a healthcare certificate of need?

Certificates of Need (CONs) are legal documents required by the District of Columbia and many states for the approval of capital expenditures and projects. The goal of CON programs is to help reduce healthcare spending by ensuring new expenses fit the community and the healthcare system need.

Definitive Healthcare collects CONs by monitoring the websites of the 36 states/federal jurisdictions with participating programs and makes the information available in our HospitalView product.

Which states require certificates of need?

Tracked by the National Conference of State Legislatures (NCSL), the 36 states and federal jurisdictions that have CON laws include:

  • Alabama
  • Alaska
  • Arkansas
  • Connecticut
  • Delaware
  • District of Columbia
  • Florida
  • Georgia
  • Hawaii
  • Illinois
  • Indiana
  • Iowa
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Jersey
  • New York
  • North Carolina
  • Ohio
  • Oklahoma
  • Oregon
  • Rhode Island
  • South Carolina
  • Tennessee
  • Vermont
  • Virginia
  • Washington
  • West Virginia

The states without CON laws are:

  • Arizona
  • California
  • Colorado
  • Idaho
  • Kansas
  • Minnesota
  • New Hampshire
  • New Mexico
  • North Dakota
  • Pennsylvania
  • South Dakota
  • Texas
  • Utah
  • Wisconsin
  • Wyoming

What is a healthcare request for proposal?

Requests for Proposals (RFPs) are documents that announce and outline the specifics of a project that a hospital or healthcare system plans to undertake. These formal requests solicit bids from suppliers and contractors to complete the proposed project.

The Definitive Healthcare HospitalView product tracks federal healthcare RFPs from the System for Award Management website and collects non-federal RFPs by monitoring state, local and healthcare entity websites for RFPs and purchasing requests.

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