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Report: Tennessee certificate-of-need laws hurt health-care access

(The Center Square) – Tennessee has been denied $1.5 billion in new health-care investment since 2000, according to a new report on the state’s certificate of need laws.

The report from Americans for Prosperity Foundation said the issues could be seen in HealthSouth’s attempt to build a 40-bed inpatient facility in Franklin. It was initially applied for in 2010, with CON granted in March 2011 but the appeals process not complete until August 2014.

A Beacon Center report last year showed that CON applications have progressively slowed in the state with 122 applications in 2004 as opposed to just 36 in 2021 and 18 in 2022.

Certificate of need laws were mandated by the federal government in 1974 and regulate how many medical facilities are available in an area and what services they provide in an effort to reduce consumer costs. Even though Congress later eliminated the CON requirement in 1987, many states retained them.

The AFP report said that states that have CON restrictions have “higher health care spending, fewer medical facilities, and inferior patient outcomes.”

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A Mercatus Center report said Tennessee would have 63 more hospitals, with 25 more in rural areas, without CON restrictions.

Tennessee’s CON law changed in 2021, when the restictions were removed for mental health hospitals, psychiatric services and some hospice and home health agencies.

The bill aimed to expedite the CON application process from 135 days to 60 days and lower costs, Senate sponsor Shane Reeves, R-Murfreesboro, said when it was discussed.

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