Why Iowa Needs Health Care Certificate of Need

Iowa’s Certificate of Need (CON) regulations were first enacted in 1977 for the express purpose of providing for the orderly and economical development of health care services, thereby avoiding unnecessary duplication of services, controlling the growth of overall health care costs and ensuring the stability of community hospitals. Since that time, these regulations have been re-examined multiple times and each time the same conclusion was reached: Iowa needs Certificate of Need.

Now the Iowa Legislature is considering a bill that, if enacted, would repeal significant portions of the CON program, putting community-based health care at risk. Here are some of the reasons why Iowa hospitals are supporting CON:

CON ensures access to health care services

  • CON repeal will reduce access by destabilizing local health care systems.
  • Without CON, services that keep hospitals financially healthy will be stripped away by for-profit, out-of-state, investor-owned organizations that selectively perform services simply because those services are likely to create the most income.
  • These niche providers would leave the financial burden on hospitals to provide 24/7/365 emergency care, to provide care for patients with complicated conditions and patients with Medicaid or no insurance.

 CON supports rural communities

  • States without CON have seen hospitals close, especially in rural areas.
  • Rural Iowa is uniquely susceptible to losing essential health care services. CON criteria and safeguards ensure health care systems are financially stable and that health care options exist throughout all of Iowa.
  • In many counties, rural hospitals are among the largest employers, bolstering Iowa’s rural economy, attracting and retaining young professionals and families and bringing high-quality jobs where they are most needed.

CON promotes quality health care services

  • CON criteria ensure new facilities operate with patient volumes that are sufficient to provide high quality services.
  • CON criteria ensure excess capacity does not lower volumes in a manner that compromises patient safety.
  • CON criteria result in consideration of the quality services available in the community.