Tennessee has used the certificate of need process to assist in regulating  the development of health care facilities and services since the 1970s, when — at the urging of the federal government — many states created health planning departments in an attempt to control increases in healthcare costs. Today, about two-thirds of the states, including Tennessee via the Health Services and Development Agency, still utilize some form of a CON process.

Tennessee's statutes governing the CON process start with a declaration from the legislature that public policy requires that "the establishment and modification of health care institutions, facilities and services shall be accomplished in a manner that is orderly, economical and consistent with the effective development of necessary and adequate means of providing for the health care of the people of Tennessee." Of the three primary components of the process, "orderly development" may often be the most complex question for the members of the HSDA to consider.

This article first appeared in Nashville Post  November 15, 2015. (login required)

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