Certificate of Need

South Carolina is one of 35 states that relies on a Certificate of Need (CON) law to safeguard patient safety and help assure that services are located so that everyone, regardless of ability to pay, has access to needed medical care. Empirical data and countless studies show a clear relationship between hospital volume and outcomes for surgical care and other medical procedures. In essence, volume = quality. The more procedures a facility performs, the better the outcomes at that facility, and this principle applies to just about every health service. CON protects against the duplication of costly medical services that can ultimately lead to lower quality and poor outcomes.

Hospitals are mission-driven organizations compelled to meet the needs of the communities they serve. But unlike any other business, hospitals are required by federal law to provide services regardless of citizenship, legal status or ability to pay. This makes it difficult to apply free-market principles to health care as you would any other business in America. That is why so many states continue to depend on CON laws to ensure that rural and underserved areas have access to quality health care. CON is not only about protecting quality for those that can pay, it’s also about ensuring access for those that can’t. 

SCHA supports the existence of the CON program, while recognizing that it is not a perfect process. Over the years, SCHA has worked with lawmakers to improve the state's CON law by simplifying the process, reducing the costs of applying for a CON, and working to ensure that it is applied fairly to all providers. CON decisions should always be based on the best interest of the public, not politics.

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