Writing Sample of Analytical Work: Discussion of CON Processes in Georgia
THE ORIGIN OF CERTIFICATE OF NEED (CON) PROCEDURES
Certificate of Need (CON) guidelines were established mainly as cost containment means by which to preclude the repetition of healthcare services and equipment.1 A CON is documentation issued by a national or state-based organization having jurisdictional influence over a region. Such certification confirms that the proposed purchase, development, or construction of a facility is needed to satisfy the medical needs of a population.
New York ratified the first CON statute in 1964, the Metcalf-McCloskey Act.2 From that time to the enactment of Section 1122 of the Social Security Act in 1972, 18 more states authorized CON directives.2 Section 1122 was passed since several states opposed rules concerning healthcare facilities and services. In 1974, national laws compelled states to formulate CON guidelines with the aim of avoiding redundancies in healthcare services, facilities, and equipment.1 States were instructed to apply governmental declarations and encourage a systematic standpoint concerning the management of healthcare delivery. Governmental involvement was stimulated by the fear that the formation of unnecessary hospital space would trigger competitors in a crowded market to contain the expenses of a thinned patient pool by overpricing services or encouraging patients to consent to hospitalization without cause.3
National guidelines authorized federal organizations to rely on the resolutions of state organizations. But, by 1987, the healthcare concerns of the federal government had shifted, leading to a reduction in support for CON programs and directives.1 States elected to either (1) maintain their CON guidelines, (2) perform analyses to reassess and/or amend their CON guidelines, or (3) decentralize the expansion and formation of new acute healthcare services. Consequently, CON procedures have become extremely...