Certificate of Need Assures Access to Care

Kentucky’s Certificate of Need (CON) law helps to assure that citizens across the Commonwealth have access to care when they need it. Hospitals generally provide a number of unprofitable services to their communities so that community access is assured for critical services despite their money-losing nature. CON makes it possible to offer those necessary but money-losing services.

  • Opponents of CON start from the flawed premise that there is a free market in health care. THERE IS NOT.
  • The federal government largely dictates health care pricing in Kentucky because 70-80% of patients in Kentucky hospitals are covered by Medicare or Medicaid.
  • Neither Medicare nor Medicaid cover the full cost of services – cost NOT charges – provided to patients.
  • The federal Emergency Medical Treatment and Labor Act (EMTALA) requires hospitals to see and treat anyone who comes into the Emergency Department regardless of their ability to pay.
  • Like 35 other states and the District of Columbia, Kentucky maintains a CON law that PREVENTS CHERRY-PICKING of certain profitable services by non-hospital health care providers.
  • Kentucky hospitals provide services at rates much lower than states without CON laws and Kentucky has more hospitals and physicians per 100,000 population and per 1,000 square miles than non-CON states and an equal number of Medicare certified ambulatory surgical centers per 1,000 square miles.
  • Kentucky has the sixth lowest price (net payment) per inpatient discharge in the U.S.
  • Given the government-driven nature of the health care marketplace, CON is crucial for patient access to care.
  • Kentucky hospitals are examining how CON can be modernized to remove unnecessary restrictions and anachronisms.

For the sake of patient health, Kentucky must retain CON.


James C. Musser
KHA Senior Vice President
Policy and Government Relations
(502) 593-2339