Mortality in Medicare beneficiaries following coronary artery bypass graft surgery in states with and without certificate of need regulation.

Abstract

Certificate of need regulation began in 1974 under federal guidelines that were designed to control health care costs by preventing health care facilities from expanding unnecessarily. Certificate of need laws also were intended to ensure quality of care and clinical proficiency by limiting the number of health care facilities performing complex medical procedures. However, opponents of certificate of need regulation argued that it may limit competition and give unfair economic advantage to established facilities. In 1984, opponents to certificate of need regulation successfully worked to enact legislation that abolished the federal government's role. This legislation allowed each state to determine whether to have certificate of need regulation.¹ With the enactment of public policies in the mid-1980s to deregulate many sectors of the economy and the emergence of competition in health care, many states, in turn, have significantly reduced certificate of need regulation or eliminated it altogether.