Iowa has one of the highest quality, lowest cost health care
systems in the United States. And at the heart of that system are 118 community
hospitals that stand ready, day and night, to serve everyone, regardless of
their ability to pay. A significant reason for health care excellence in Iowa
has been state oversight of institutional health care services through the
Certificate of Need (CON) law.
Iowa’s Certificate of Need 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.
As the name implies, Certificate of Need ensures that new
medical services are truly needed at the community level. This is important
because new facilities (including nursing homes, ambulatory surgical centers
and hospitals, among others) must have sufficient patient volumes to support
proficiency among medical staff and ensure high-quality care. The same applies
to existing facilities, yet without Certificate of Need, new, for-profit
facilities would spring up all over the state and deplete patient volumes
across the board.
Not only would this compromise the quality of care for
everyone, but these new facilities would target lucrative lines of medical
service while not providing emergency care, charity care and other unprofitable
services that are at the core of the community hospital mission. If Iowa’s
community hospitals are left with only unprofitable services and only care for
complicated patients who are on Medicaid or uninsured, their ability to survive
and continue providing high-quality, community-focused care to everyone will be
In fact, repeal of the law in other states has led to hospitals
closing. Furthermore, nearly all of these states have instituted a different
review process that is highly politicized.
One of Iowa’s greatest strengths is its health care system.
Not only do Iowa’s health care providers deliver excellent, accessible and
efficient care, but health care employs more than 200,000 people, injecting
some $11 billion into the state’s economy. More than 71,000 of these workers
are employed by hospitals, which alone have an economic impact of $4.3 billion.
Certificate of Need, which exists in 36 states, not only
ensures the stability of these major employers and economic engines, but it
also supports the collaborative spirit that fosters communication and
cooperation among Iowa health care providers, which, again, leads to better
health care for everyone.
Today, with the uncertainties surrounding the future of the
Affordable Care Act (Obamacare), Iowa’s Medicaid program and even Medicare, the
constancy of Certificate of Need is more important than ever. During this time
of significant change in the health care industry, the stability provided by this
law allows hospitals to more confidently plan and respond to the needs of the
communities they serve.
In all parts of the state, Iowans depend on their community
hospitals being there all day, every day. That level of access and preparedness
is jeopardized by those who would significantly change or repeal Certificate of
Please help by
contacting your local representative, Mark Segebart (firstname.lastname@example.org) or Gary Worthan (email@example.com) if you share in the opposition to repeal a
CON which will ensure we are able to continue to provide critical health care
services within our community.