The Certificate of Need (“CON”) program is a regulatory review process used to promote responsive health facility and service development, rational health planning, health care quality, access to health care, and health care cost containment. Since its beginning as part of the federal Health Planning Resources Development Act of 1974, states have both developed and repealed respective CON programs. Currently, approximately 36 states, including Kentucky, retain some type of CON requirements for certain health care providers and services.

Across the country, however, states are reviewing their CON programs with an eye to modernization. One of the primary reasons for this review is a response to the Patient Protection and Affordable Care Act (“ACA”) and its standards for quality and efficiency of care. The Commonwealth of Kentucky is no exception. Its Cabinet for Health and Family Services’ Office of Health Policy (“Cabinet”) is currently conducting a modernization of the Commonwealth’s CON program with the vision of achieving “The Triple Aim: Better Value, Better Care and Population Health Improvement.” The goal is to assure the Commonwealth is able to provide all necessary health services to its residents through a revised/modernized regulatory CON review process.

The Cabinet announced in October of 2014 that this modernization process would center on seven core principles:

1. Supporting the evolution of care delivery

2. Incentivizing development of a full continuum of care

3. Incentivizing quality

4. Improving access to care

5. Improving value of care

6. Promoting adoption of efficient technology

7. Exempting services for which CON is no longer necessary

As part of its process, the Cabinet conducted stakeholder meetings on March 16 and March 17, 2015. In lieu of, or in addition to, attendance, stakeholders were requested to submit written comments as to suggested changes to the CON program and how those changes would help further implement the Cabinet’s core principles. 

This is an exciting time for health care facilities and providers. Allowing providers to participate in the development of the CON program and offer input regarding their organization’s missions and need to provide health care services will produce a CON program with viability and effectiveness for the future.