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Certificate of Need

South Carolina is among 35 states that rely on a Certificate of Need (CON) process to expand, build or add certain medical services. The state’s hospitals and health systems believe that a fair and reasonable CON program is critical to ensuring that everyone has access to care when they need it. Hospitals are required by federal law to treat everyone who walks through their doors, regardless of ability to pay. Meanwhile, other facilities like outpatient surgical and diagnostic centers have the ability to avert patients that are uninsured or underinsured that often end up in hospital emergency departments.

This leads hospitals to become the primary source of care for many uninsured individuals. And while opponents of CON argue that it obstructs the “free market,” the U.S. government remains the largest purchaser of healthcare services through Medicaid and Medicare — providers with whom hospitals cannot negotiate and reimburse hospitals less than cost. This only increases the hospital’s reliance on commercially insured patients as many rural facilities struggle to keep their doors open. CON helps provide a process that protects access to care for every South Carolinian.

SCHA supports modernizing the state’s CON laws to limit the appeals process, reduce the projects that require approval and streamline the system. We recognize that South Carolina’s CON program needs to be updated to reflect the needs of today’s growing health systems.