Mississippi State Health Officer Dr. Daniel Edney, addresses members of the Mississippi Joint Legislative Budget Committee during his budget presentation for the state Department of Health, Friday, Sept. 29, 2023, in Jackson, Miss. (AP Photo/Rogelio V. Solis)
- Proposed changes include increased access to psychiatric, substance abuse and perinatal care. Concerns remain over cherry-picking of profitable services.
Members of the Select Committee on Healthcare Reform in the Mississippi House of Representatives heard from medical professionals earlier this week about how CERTIFICATE OF NEED (CON) laws affect access to healthcare.
The meeting included proposed changes aimed at increasing access to healthcare while protecting existing services.
The Select Committee is one of several formed by Speaker of the House Jason White (R) earlier this year. Each committee has been tasked with working in the off season to gather additional information that can be presented during the 2025 legislative session.
The Select Committee on Healthcare Reform is co-chaired by State Representatives Samuel Creekmore (R) and Hank Zuber (R).
“With Speaker Jason White’s leadership, he has charged us to look at the entire CON process and to put everything on the table,” Rep. Zuber told Magnolia Tribune after Monday’s meeting. “We believe that there may be some changes that can be made to make healthcare more affordable, accessible and of a higher quality especially in parts of the state where we have medical deserts.”
Monday’s meeting featured presentations from State Health Officer Dr. Daniel Edney, Mississippi Hospital Association President Richard Roberson, and James Grantham with Baptist Memorial Health Care, to name a few, Rep. Creekmore said. Each spoke about the areas where CON can be effectively changed, or where the laws protect the healthcare industry.
Co-chairman Creekmore said Mississippi enjoys relatively affordable healthcare options.
“We have the lowest healthcare costs in the United States, which is a good thing,” Creekmore said.
Dr. Edney focused his presentation on changing laws to allow for increased access to psychiatric, chemical dependance and perinatal services. He also had one other major suggestion – reforming the process by which existing providers are allowed to oppose the applications of their would-be competitors.
“The other recommendation that could really help would be to look at appropriate reform of the appeals process, which is really what inhibits a lot of people who have an application that is going to be approved by the Department of Health and yet it’s opposed by other stakeholders,” Edney told Magnolia Tribune. “And that can be an expensive two-year long process to litigate and almost always comes out to the same resolution, that our ruling is sustained.”
Current CON laws also include monetary caps on medical facility investments. Dr. Edney said they stand at $1.5 million for equipment purchases, $5 million on clinical changes such as increasing bed counts, and $10 million on non-clinical investments, such as building new or adding on to existing facilities.
Rep. Creekmore said those regulations are in the committee’s crosshairs.
“So, we’re looking at raising those thresholds up to make it easier for hospitals and clinics to get equipment or build a building without having to get a certificate of need,” Creekmore said.
CON laws, as they stand today, also prevent hospitals from providing dialysis care, which is one area a medical facility representative informed the committee should be changed.
Rep. Creekmore added that expanding psychiatric and substance abuse care are changes that could be easily reformed.
“It sounded to me like psychiatric and substance abuse were areas that we could look at for some low hanging fruit to do away with CONs,” Creekmore added about Monday’s discussion. “And that would also increase availability for those fields in Mississippi.”
An area where CONs serve to protect access to healthcare, Edney said, is by preventing cherry-picking of desirable services because they are profitable, leaving small hospitals with providing services that are not as profitable and putting them in financial danger. That is especially true in healthcare deserts, where investment in services has stagnated.
“I think there’s a lot of agreement that CON reform is needed,” Dr. Edney stated. “But it’s important that we don’t throw the baby out with the bathwater. The one thing CON does really well is prevents cherry-picking. That’s one thing that can kill a small rural hospital.”
The next meeting of the Select Committee is slated for September 10. Rep. Zuber said there is talk of holding another meeting later this year as well.
“We are looking at and reviewing that whole process, which hasn’t been fundamentally changed or reviewed in 40 years,” Zuber said.
