Certificate of Need Procedure Criticized

A U.S. scientist said a government regulation designed to cut hospital mortality rates and costs does neither in two common heart procedures.

Dr. Vivian Ho, associated with both the Baylor College of Medicine and Rice University, said Certificate of Need regulations deliver only minor benefits in cases of open heart surgery and no benefits in instances of angioplasty.

Certificate of Need rules prevent hospitals that do not provide care to a prescribed volume of patients from offering heart surgery and similar cardiac procedures.

For cardiac procedures, Certificate of Need doesn’t create the kind of savings and reductions in mortality rates that policymakers thought it would achieve, said Ho.

She hypothesizes Certificate of Need regulations, which mandate a minimum number of procedures per year might inadvertently compel hospitals to encourage surgery for some patients for whom medication would suffice. The hospitals may perceive they need to perform the extra procedures to meet the regulation’s minimum volume quotas.

Thirty-five states and the District of Columbia administer Certificate of Need programs.

Ho’s study is reported in the online edition of the International Journal of Health Care Finance and Economics.