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How Tennessee’s Outdated Certificate-of-Need (CON) Laws Limit Healthcare Access and Threaten the State’s Future

January 12, 2023

Healthcare can be expensive and complex. But Tennessee’s rules and restrictions are making it worse, often for those who can least afford care. Adopted in the 1970s, certificate-of-need (CON) laws require a government permission slip before providing most healthcare services, such as opening a new hospital or purchasing high-tech medical equipment. Imagine if every new restaurant had to get permission from other food establishments to open its doors or even buy a new fryer or drink machine.

As absurd as it sounds, this is exactly what would-be healthcare providers must do—often with little public input or transparency. Over the last 20 years, approximately 1 in 5 healthcare innovations that require CON approval were rejected in the state of Tennessee.

As a result, many facilities have never opened their doors or expanded to serve some of the state’s most vulnerable communities. They were outright rejected, their permits expired, or they never risked the enormous investments of time and money to navigate this onerous and risky application process. In fact, if we repealed all of Tennessee’s current hospital CON laws, there could be up to 63 more hospitals in the state, with 25 located in rural areas.

Read the rest of the report here.

Naomi Lopez is Vice President for Healthcare Policy at the Goldwater Institute.
Amanda Hagerman is a Healthcare Policy Analyst at the Goldwater Institute.
Ron Shultis is the Director of Policy & Research at the Beacon Center of Tennessee.
Jason Edmonds is the Policy & Research Associate at the Beacon Center of Tennessee.



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