Editor’s Note: No one should be surprised that consumers continue to spend more money on healthcare costs each year. Insurance premiums, higher deductibles and other out-of-pocket costs are a few of the challenges Americans face today. I’ve seen it personally in my own life with both my mother and sister Vickie who are in nursing homes. Sadly, Vickie lost everything to her name.
According to NCSL, National Conference of State Legislatures, In the past several years, many states have introduced or enacted legislation to modify their CON programs. Changes range from fully repealing an existing CON program to creating a new CON program. However, most state legislation makes targeted changes to CON oversight, such as excluding specific facilities from CON review.
- Currently, 35 states and D.C. maintain some form of CON program. States with CON laws most often regulate hospitals, outpatient facilities and long-term care facilities.
- As of 2021, 12 states have fully repealed their CON programs or allowed the program to expire. New Hampshire was the most recent state to repeal its CON program in 2016.
- Three states—Arizona, Minnesota and Wisconsin—do not officially operate a CON program, but they maintain several approval processes that function similarly to CON.
- In 2020, at least six states—Michigan, New Jersey, Vermont, Virginia, Washington, and West Virginia—enacted legislation to modify their CON laws in some capacity. Additionally, five states—Michigan, Montana, North Carolina, Tennessee and Washington—and Washington, D.C. enacted CON legislation in 2021. Montana’s legislation was the most sweeping of these bills, exempting all facilities except long-term care facilities from CON review.
- Related to CON, at least 13 states have a moratorium on certain health care activities and capital expenditures, meaning they will not grant CON or state approval for a specific activity. Moratoria are most common for long-term care related activities, such as expanding the number of long-term care beds in a facility.
Vanderbilt University Medial Center Approved
Members of a state health agency panel on Wednesday approved plans by Vanderbilt University Medical Center to build a new $144 million hospital in Rutherford County over strong objections from competing hospitals already serving patients in the fast-growing Middle Tennessee suburbs.
It is Vanderbilt’s second attempt to gain state permission — in the form of a state-issued certificate of need, required before building or expanding hospital capacity — to establish a new 42-bed facility by 2026 on 80 acres it already owns in Murfreesboro. The Tennessee Health Services and Development Agency rejected Vanderbilt’s first proposal last year.
Since then, state law governing certificates of need has been revised, in part to add that “consumer advantage” must now be taken into consideration.
Tennessee Republican legislators target unpopular regulation as they look to lower health care costs and increase access. https://www.ucbjournal.com/sexton-reviews-states-top-legislative-priorities/
Vanderbilt filed its renewed application on October 1, the same day the new certificate of need rules went into effect. And on Wednesday, as the agency’s six-member panel heard more than three hours of testimony, it became clear the new criteria for granting a certificate of need worked to Vanderbilt’s advantage.
“The facts have grown much stronger in support of this application and the CON (certificate of need) law has change to favor this application,” Dan Elrod, Vanderbilt’s attorney said Wednesday.
The hospital is needed to keep up with growing demand in Rutherford County, where thousands of residents already battle busy I-24 traffic to seek care at one of Vanderbilt’s existing facilities, Elrod said. The new hospital would also relieve the burden at Vanderbilt’s main Nashville campus, which has operated at near capacity. And it would add pediatric beds to a county with 70,000 children under the age of 14.
”Vanderbilt Hospital is one off the most respected Healthcare providers in the nation. Having VUMC build a new hospital in Rutherford County is great news for us all,” said Tennessee Representative Tim Rudd.
Representatives from TriStar Stonecrest Medical Center, Ascension St. Thomas and Williamson Medical Center tried to convince the board that Vanderbilt’s move into Rutherford County was not an attempt to serve an underserved population, but instead a clear effort to divert patients away from existing community hospitals that are adequately serving patients.
“Vanderbilt University Medical Center’s project was denied last year because there was no need. That has not changed,” said Gordon Ferguson, president and CEO of Ascension St. Thomas Rutherford Hospital.
One longstanding criteria used to guide the Health Services and Development Agency in deciding whether to approve a new hospital is whether existing hospitals in a community were at 80% of capacity for two years in a row.
“This does not meet that 80% threshold,” said Lou Caputo, CEO of TriStar Stonecrest Medical Center. “They are offering no new services; it is simply a duplication of services already offered in the community….We have more than 200 surplus beds in the county.”
Ultimately, five of six members of the panel deciding Vanderbilt’s application were unpersuaded by opposition from competing hospitals. Only one voted against Vanderbilt’s plans.
“The CON (certificate of need) is not about anti-trust or anti-competitiveness,” said Dr. Kenneth Patric, an agency member who voted in favor of Vanderbilt’s expansion plans. “It is about consumer protection and consumer advantage. It seems to me there’s a lot of consumer support for this and that seems to me ought to be the litmus test.”
It’s unlikely the fight to prevent the new hospital, to be called Vanderbilt Rutherford Hospital, is over. In a separate legal action, Rutherford County’s existing hospitals and Williamson Medical Center filed suit in Davidson County Chancery Court seeking to preserve records in a previous legal fight over Vanderbilt’s first hospital application. The suit indicated the hospitals wanted those records preserved for an inevitable legal fight over Vanderbilt’s latest attempt to build a new hospital.