Social and Behavioral Sciences Commons^™

Institutional Design And Regulatory Performance: Rethinking State Certificate Of Need Programs, Robert B. Hackey, Peter F. Fuller

Health Policy & Management Faculty Publications

The success of state efforts to control rising health care costs depends on the incentives contained in the legislative design of regulatory policies and in the administrative capacity and autonomy of state agencies. States have regulated the construction and expansion of health care facilities and services for more that two decades through “certificate of need” (CON) programs designed to limit the diffusion of expensive new medical technologies and to avoid the duplication of health care facilities. Although the cost-control record of state certificate of need programs has been widely criticized, Rhode Island’s experience with a reformed CON process from 1985 …