Hospitals’ unity fractures on big-ticket legislative battle

Piedmont Health supports outpatient surgical facility.

The biggest political battle in the 2019 legislative session may be the knotty struggle over a state hospital regulation, certificate of need, or CON. And it has now claimed a big casualty: The Georgia Hospital Association’s unity is cracking.

Mostly, the CON battle has two sides: private treatment facilities and the entrepreneurs who want to establish them versus nonprofit hospitals. Hundreds of millions of dollars in patient revenue may be at stake statewide.

The businesses say CON prevents or slows them from opening facilities that would give patients more choice. The hospitals say CON protects them by preventing businesses from cherry-picking their moneymaking services and leaving them obligated to provide all the money-losers, such as neonatal care. The Georgia Hospital Association is a key player in the battle, representing hospitals in metro Atlanta and across the state, including the handful of big health care systems. The hospitals oppose the legislation filed in the House to repeal CON, House Bill 198.

The hospital association on Jan. 8 said it would compromise on CON, supporting some easing of the regulation for the private business Cancer Treatment Centers of America. Where it held fast was on the bigger threat, outpatient surgery centers.

On Thursday, one of the hospital organizations that participated in developing that statement, Piedmont Health System, broke away and came out with its own letter. Piedmont will now support not only CTCA concessions but an outpatient surgery facility that the business Legacy Sports wants to open in Alpharetta.

Ethan James, executive vice president of the Georgia Hospital Association, said the letter shows Piedmont is still in agreement on the core principles of CON.