Certificate of need laws, which require special approval from state governments to expand or build new facilities, can pose challenges for patient access.
Here’s how CON laws, or the lack thereof, affect spine surgeons in two regions of the U.S.
Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. Becker’s invites all spine surgeon and specialist responses.
Next question: How do current liability laws affect your surgical decision-making?
Please send responses to Carly Behm at cbehm@beckershealthcare.com by 5 p.m. CDT Tuesday, May 6.
Editor’s note: Responses were lightly edited for clarity and length.
Question: Are certificate-of-need laws helping or hurting spine surgery access in your region?
Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: Certificate of need (CON) laws have historically hurt access. The lobbying power of certain players in the hospital industry have relied on these to enact hurdles to smaller competitors that will provide possible lower prices and better outcomes. While there needs to be reasonable restrictions on opening new hospitals next to each other, so that they don’t drive each other out of business, I feel they are burdensome and hinder patient access. If doctors cannot own hospitals, hospitals should not own the laws governing their own competition.
Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): Idaho is currently not a sanctioned certificate of need state and has witnessed an alarming increase in for profit surgery centers. Access to healthcare remains tenuous for other enigmatic reasons, but most care follows insurance preferences and physician bias. This effort to garner a subset of unambiguous patients subsequently concentrates more higher acuity caseloads and inadvertent cost shifting to larger health systems. The burdensome nature of this practice ‘culture’ continues to affect patient management schemes for providers and payers alike. A policy change may be in order.
