Healthcare Insights

Most common types of certificates of need

The District of Columbia and many states in the U.S. require Certificates of Need (CONs) for the approval of healthcare capital expenditures and projects. These programs aim to control healthcare costs by ensuring new expenses fit community and healthcare system needs.

In the Definitive Healthcare HospitalView product, we collect CONs by monitoring the websites of the 36 states/federal jurisdictions with participating programs. Since 2018, more than 11,400 healthcare CONs have been recorded.

To provide insight into the types of capital projects that hospitals are undertaking, we ranked the most frequent categories for healthcare CONs between January 2018 and September 2022.

Top 10 most common hospital certificate of need categories

RankCON categoryNumber of CONsExplore dataset
1Change in ownership/stock/management2,234Explore
2Hospital/facility renovation1,981Explore
3Certify new unit/service1,834Explore
4Equipment new/replace1,721Explore
5New hospital/unit1,606Explore
6Change in beds status/number/classification1,057Explore
7Certify/change service474Explore
8Hospital/facility relocation408Explore
9Transfer equipment75Explore
10Hospital/facility closure41Explore

Fig. 1 Data is from the Definitive Healthcare HospitalView product. CONs and hospital purchasing data are from a variety of sources and updated daily. Data accessed October 2022.

What is the most common CON type?

Changes in ownership, stocks, or management CONs for healthcare organizations are the most common with more than 2,200 recorded between January 2018 and September 2022. These CONs cover network affiliation changes and funding news.

Hospital and facility renovations are the second most common CON type and track construction projects. The remaining top categories with more than 1,000 CONs between January 2018 and September 2022 include:

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