Last month the Georgia Supreme Court heard a case that could have far reaching impact not only on the health of all Georgians, but that of communities throughout our state. Women’s Surgical Center, LLC et al v. Berry et al challenges the need for the state’s Certificate of Need laws, which for over 30 years have ensured access to care for all Georgians regardless of where they live, how serious their medical need, or their ability to pay.
The court’s decision will come at a critical time. Hospitals, already struggling to meet the financial challenges caused by unfunded mandates, changing populations and growing numbers of uninsured, are now faced with one of the most shocking health crises our state has seen in decades– the opioid epidemic.
A recent report by the Agency for Healthcare Research and Quality noted that opioid related admissions in Georgia nearly doubled between 2009 and 2014. Just last month, five people died and 30 were hospitalized in middle Georgia after overdosing on a dangerous form of fentanyl. Every patient who comes to the emergency room because of an overdose impacts a hospital’s capacity to treat other patients, underscoring the critical need for a viable network of care.
Ensuring the continued strength, if not existence, of Georgia’s community hospitals is not only a healthcare issue, it is an economic issue. The not-for-profit hospitals in communities from Dalton to Brunswick and everywhere in between are typically one of the largest employers, creating quality jobs that grow the tax base and support the local economy in addition to the patients who come through their doors 24 hours a day, seven days a week. They also play a key role in economic development. Ask any location expert and they will confirm that companies do not want to locate in communities without access to quality care. And, as the House Rural Development Council is learning first hand as it conducts meetings across the state, rural Georgia needs all the leverage it can get to attract and maintain industry.
Without question, one of the keys to the stability of Georgia’s network of care is the state’s Certificate of Need program. This critical tool helps the state ensure access to care as well as the financial stability of the safety net and community hospitals that rely upon a delicate balance of payor mix and reimbursement levels from insurance companies and the state and federal government. Allowing for-profit entities to siphon away insured patients for procedures that receive higher reimbursement rates directly impacts a not-for-profit hospital’s ability to cover the cost of emergency and trauma centers as well as other services that are reimbursed at far less than the actual cost.
The fact is, healthcare is not a free market– nor will it ever be. Consumers typically do not understand the true costs of care, nor is there sufficient information to compare services by different providers or different facilities. There will likely always be some level of government mandate. And, we are compassionate nation that will not and should not refuse care based solely on the ability to pay.
If patient choice is truly the driving argument of the opponents of Georgia’s Certificate of Need laws, their fears can be put to rest. Expert testimony recently commissioned by the Georgia attorney general’s office demonstrated that these laws can actually reduce healthcare costs, improve the quality of care, and expand access– all sound reasons for these laws to be upheld.
All Georgians deserve access to quality care. Keeping our Certificate of Need laws in place has played a key role in providing that access for over thirty years and if left in place will do so for decades to come.
The author is president of the Georgia Alliance of Community Hospitals.