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| Subject:
What states collude with Hospitals to limit building of new competing hospitals?
Category: Health Asked by: ed777-ga List Price: $75.00 |
Posted:
01 Sep 2005 09:52 PDT
Expires: 01 Oct 2005 09:52 PDT Question ID: 563122 |
What states DO/DON?T collude with Hospitals to limit the building of new competing hospitals and thus cause daily room rates, indicated in medicalcountries.com, as high as $4000+ in U. S. hospitals compared to $11.00 a day in some other countries. |
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| Subject:
Re: What states collude with Hospitals to limit building of new competing hospitals?
Answered By: bobbie7-ga on 01 Sep 2005 12:14 PDT Rated: |
Hello Ed777,
CERTIFICATE OF NEED ("CON"):
What is a certificate of need?
?A certificate issued by a governmental group to an individual or
institution or organization proposing to create or modify a health
facility, or to offer a new or different type of service.?
Public Health Management & Policy: Dictionary
http://www.cwru.edu/med/epidbio/mphp439/Dictionary.htm
?A Certificate of Need ("CON") is a permit for the establishment or
modification of a health care institution, facility or service,
purchase of major medical equipment, or establishment of certain
services at a designated location. The CON program serves as a growth
management and cost savings tool since it requires certain health
providers to establish the need for new services and facilities before
the providers will be allowed to build facilities, becomes licensed,
or conduct certain business.?
http://www.tennessee.gov/hsda/cert_need_basics.html
The report ?Certificate of Need Programs: A Comparative Assessment?
prepared for the Illinois Health Facilities Planning Board, provides
an overview of States with CON programs.
Published: June 30, 2004
Chapter II presents an overview of the CON programs across states that
currently regulate and do
planning on health care facilities.
Illinois uniquely gives the authority to the State Board for both the
duties: 1) approving
standards/criteria and 2) making final decisions on applications.
Michigan, New Jersey and Florida?have Health Department directors make
final decisions on applications and have independent councils enhance
and approve standards/criteria.
New York has the Health Department director make final decisions on
projects except for full review establishment projects on which the
Public Health Council make final decisions.
Below you will find the list of States that have Certificate of Need requirements.
The listing provides the State and the final decision maker
Alaska
Agency
Commissioner of Health & Social Services
Arkansas
Agency
Health Services Permit Agency (can be appealed to 9 person Commission
appointed by Governor)
Connecticut
Agency
Head of Office of Health Care Access
Delaware
Board
Delaware Health Resources Board
D.C.
Agency
Director
Florida
Agency
Agency for Health Care Administration
Georgia
Agency, or Review Board
Hawaii
Agency
Administrator
Illinois
Board
Illinois Health Facilities Planning Board
Iowa
Board
State Health Facilities Council (Five members, appointed by the Governor)
Kentucky
Attorney
Hearing Officers (State Attorneys)
Maine
Agency
Commissioner, Department of Human Services
Maryland
Board
Maryland Health Care Commission (13 member)
Massachusetts
Board
Public Health Council
Michigan
Agency
Director, Michigan Department of Community Health
Mississippi
Agency
State Health Officer
Missouri
Board
Missouri Health Facilities Review Committee (9 members)
Montana
Agency
Directors, Department of Public Health and Human Services
Nebraska
Agency
Nebraska Health and Human Services Regulation and Licensure
Nevada
Agency
Director, Department of Human Resources
New Hampshire
Board
Health Services Planning & Review Board
New Jersey
Agency
Commissioner of Health and Senior Services
New York
Agency and Board
Commissioner of Health (services for existing providers),
NYS Public Health Council (establishment projects)
North Carolina
Agency
Chief, Certificate of Need Section
Ohio
Agency
Director of Health
Oklahoma
Agency
Commissioner of Health
Oregon
Agency
Public Health Officer
Rhode Island
Agency
Director of Health
South Carolina
Board
Board of Health & Environmental Control
Tennessee
Board
Health Services & Development Agency (9-member board)
Vermont
Agency
Commissioner, Department of Banking, Insurance, Securities, and Health
Care Administration
Virginia
Agency
Commissioner of Health
Washington
Two ways
Office Chief makes initial decision;
Secretary of DoH makes final decision on appeals
West Virginia
Board
Health Care Cost Review Board (3 members)
Wisconsin
Agency
Secretary, Department of Health and Social Services
Table 2.2 Summary of Decision Making for CON Applications
Download full text of this report here:
http://www.idph.state.il.us/about/hfpb/CON%20Programs%20A%20Comparative%20Assessment.pdf
Search terms:
Certificate of need requirements, CON, States, legislation, health facilities,
hospitals,
I hope the information provided is helpful!
Best regards,
Bobbie7 | |
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ed777-ga
rated this answer:
and gave an additional tip of:
$50.00
Your wonderful research shows how the States can eliminate competition, allocate markets, and increase medical costs for its citizens by their misuse of the law. |
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| Subject:
Re: What states collude with Hospitals to limit building of new competing hospitals?
From: bobbie7-ga on 14 Sep 2005 13:38 PDT |
Thank you for the five stars and nice tip! --Bobbie7 |
| Subject:
Re: What states collude with Hospitals to limit building of new competing hospit
From: gasdoc-ga on 22 Sep 2005 07:05 PDT |
Your assumption that certificates of need equals increased cost through elimination of competition is erroneous. Read the excellent article at: http://www.ajmc.com/files/articlefiles/AJMC2003junBCROSSHaySP13.pdf. Essentially, increased cost of inpatient healthcare in recent years is most closely related to increased use of technology, procedures, and overall declining health of the American population. However, to provide evidence that certificates of need to not correlate with the cost of healthcare delivery, please look at the following table. I have placed asterisks next to the states that do not require a certificate of need. As you can see, some states, such as California, are very expensive, yet do not require a certificate. On the other hand, Montana and Mississippi do require them but are relatively inexpensive. I think you can find epidemiological clusters in some of the states (such as South/North Dakota, Wyoming, Kansas) that can account for alternative explanations of lower cost of healthcare delivery. (Table adopted from http://www.statehealthfacts.org/cgi-bin/healthfacts.cgi?action=compare&category=Health+Costs+%26+Budgets&subcategory=Hospital+Inpatient+Day+Expenses&topic=Expenses+per+Inpatient+Day) 1 Alaska $1,952 2 Oregon $1,842 3 Washington $1,827 4 District of Columbia $1,824 5 California $1,763 **** 6 Connecticut $1,684 7 Utah $1,654 **** 8 Massachusetts $1,631 9 New Jersey $1,615 10 Nevada $1,608 11 Rhode Island $1,591 12 Maryland $1,571 13 Arizona $1,570 **** 14 New Mexico $1,563 **** 15 Colorado $1,551 **** 16 Delaware $1,508 17 Ohio $1,504 18 Illinois $1,497 19 Texas $1,482 **** 20 Maine $1,416 21 Missouri $1,403 22 New York $1,402 23 New Hampshire $1,389 24 Florida $1,387 25 Michigan $1,382 26 South Carolina $1,355 27 Indiana $1,352 **** 28 Hawaii $1,350 29 Pennsylvania $1,326 **** 30 Wisconsin $1,282 31 Virginia $1,277 32 Idaho $1,235 **** 33 North Carolina $1,200 34 Tennessee $1,187 35 Louisiana $1,177 35 Oklahoma $1,177 37 Alabama $1,166 38 Vermont $1,148 39 Arkansas $1,130 40 Minnesota $1,109 **** 41 Kentucky $1,106 42 Georgia $1,044 43 Nebraska $1,043 44 West Virginia $993 45 Iowa $952 45 Kansas $952 **** 47 Wyoming $943 **** 48 Mississippi $882 49 North Dakota $859 **** 50 South Dakota $747 **** 51 Montana $733 |
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