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ATLANTA — Laws to reform or scrap Georgia’s certificates of wants legal guidelines for well being care services stalled within the 2023 legislative session however now committees are assembly to find out the easiest way ahead.
The Senate, in a 42-13 vote Feb. 27, authorized Senate Invoice 99, which might exempt acute care hospitals seeking to find in rural counties (or counties with lower than 50,000 residents) from adhering to CON necessities. The invoice, nonetheless, stalled within the Home.
State Sen. Greg Dolezal, the invoice’s sponsor, mentioned the proposal was the results of an undisclosed well being care developer’s curiosity in constructing one other hospital in Butts County the place the inhabitants is lower than 26,000. The county at the moment has Wellstar Sylvan Grove Medical Heart in Jackson.
Sen. Ben Watson sponsored one other invoice, SB 162, that might have repealed CON in its entirety. The invoice, nonetheless, didn’t make it out of its Senate committee.
Opponents of CON say the restriction has contributed to the rising price of well being care, whereas proponents of CON mentioned it helps present stability and a repeal might negatively have an effect on rural hospitals which must compete with newer hospitals.
Lawmakers handed a decision this session to create the Certificates of Want Reform Examine Committee to find out methods to have higher well being outcomes at decrease prices and to find out insurance policies for financially struggling rural hospitals to outlive and develop.
The committee, appointed by Lt. Gov. Burt Jones, first met June 13.
Jocelyn Hill, a senior coverage analyst within the Georgia Senate Analysis Workplace, offered analysis to the committee from numerous reviews and research on CON legal guidelines and their have an effect on on expenditures, regulatory prices, well being care final result and entry to care.
“The outcomes offered combined outcomes with common findings that certificates of want will increase well being expenditures and general aged mortality whereas lowering coronary heart surgical procedure mortality,” Hill mentioned. “They’d combined outcomes amongst their completely different outcomes in several classes that they had been . Their conclusion was that based mostly on their critiques, and what they checked out that, CON legal guidelines aren’t essentially assembly the aims that they had been put in place for.”
CON necessities had been signed into federal regulation within the mid-Nineteen Seventies as a option to assess the provision and duplication of well being care providers inside a sure radius. Congress repealed it almost a decade later leaving it to states to determine.
Twelve states have performed away with CON legal guidelines, most not too long ago South Carolina this 12 months establishing a three-year sundown for its CON program. Counties with out hospitals, nonetheless, can transfer ahead with constructing hospitals and clinics.
Although particular procedures and prices diversified amongst completely different states, Hill mentioned CON laws led to decrease high quality look after some measures of high quality and have little to no impact on different measures of high quality.
Thomas Stratmann, a senior researcher on the Mercatus Heart at Georgia Mason College, mentioned Georgia ranks seventh with highest variety of CON legal guidelines.
For instance, Georgia legal guidelines require hospitals to get approval so as to add a brand new mattress, to open a brand new hospital, to buy a MRI machine or CT scanner and to open up an ambulatory surgical procedure middle.
He mentioned states with CON legal guidelines have much less affected person entry to medical care and decrease high quality of medical providers.
“The information reveals fewer hospitals in CON states than states with out CON,” Stratton mentioned. “Round 2017, Georgia had 175 hospitals, comparable states to Georgia with out CON has 227 hospitals. So a state with out CON has greater than 30% extra hospitals. So this reveals us additionally that CON reduces entry to medical care as a result of there are fewer hospitals accessible.”
Ana Adams of the Georgia Hospital Affiliation, representing greater than 140 hospitals throughout Georgia, informed committee members to keep away from an entire CON repeal. Maintaining some restrictions, she mentioned, might shield high quality and forestall proliferation of 1 service.
“We’ve got points throughout the state with entry to trauma care. We’ve got points with maternal mortality. Every of these issues is a very giant substantial challenge that I believe all of you need to deal with and have been attempting to handle and so they’re not essentially linked to certificates of want,” Hill mentioned. “So what we might ask is that you simply type of take a holistic strategy to well being care, attempting to determine the place we will make some adjustments that shall be useful for hospitals, doctor practices, nurses, and many others.”
The committee will set future assembly dates for August in Columbus, Savannah in October and the State Capitol in November.
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