What does COPN stand for?
COPN stands for Certificate of Public Need. It is also sometimes referred to as CON, or Certificate of Need.
What is COPN?
COPN is a law that requires healthcare providers and facilities get permission from the government before they can offer certain services, purchase certain equipment or expand their facilities. For example, in Virginia, a provider must obtain a COPN before they can purchase a MRI machine for use in their facility.
Imagine this: You own a small grocery store and many customers have been asking you to add a seafood department to your store. They currently have to drive an hour away to buy seafood at a much larger store, where the prices are much higher. It would be much more convenient for them to buy seafood at your store, where they already are shopping. It would also allow you, as a business owner, to serve your consumers best and expand your business to meet their needs. However, you must first get permission from the government to do so. The process takes a very long time and is very costly. At the end of the process, you are denied the request because there is already another store selling seafood. Sounds absurd right? That’s COPN!
How did COPN start?
COPN was originally implemented in the 1970s with the intent of controlling costs and increasing access to care. It has failed to do any of this. In fact, the federal government repealed its COPN program in 1987 and numerous states have followed since.
How many states have repealed their COPN laws?
As of December 2016, 15 states have repealed COPN. 35 states and the District of Columbia have less strict, reformed or some level of COPN programs.
How does Virginia’s COPN program compare to the rest of the country?
Virginia’s COPN program is the 11th strictest in the country. While 35 other states still have some form of COPN, they are at varying levels. According to the Mercatus Center, Virginia currently rules 19 different services, devices and procedures, which is higher than the national average.
Are there benefits to COPN?
When COPN was originally created, it was intended to contain healthcare costs and increase access to care. Unfortunately, it did not achieve these goals and instead, has accomplished the opposite. The Mercatus Center concludes that 40 years of evidence demonstrates that these programs do not achieve their intended outcomes.
Why Do We Need to Reform COPN?
Virginia’s current COPN laws increase health care costs, threaten access to care and limit competition and innovation. Virginia citizens will directly benefit from a significantly reformed COPN program.
Who opposes COPN reform?
The main opponents to reforming COPN are hospitals. COPN regulated services are a major revenue generator for hospitals and help them offset the costs of providing uncompensated care. If COPN is reformed, competition will increase and the costs of these services will decrease. This will impact the hospitals’ profits.
How will COPN reform lower health care prices?
Data shows that healthcare costs are 11 percent higher in states with COPN than in states without it. The current program artificially limits health services by blocking competition, limiting choice and inflating the cost of service. As the only provider in a region, a hospital can use this as leverage to raise prices. Patients, insurers and businesses bear the financial brunt of this lopsided market force. Reforming COPN will increase competition and result in lower costs for patients.
How will COPN reform expand access to health care?
COPN currently blocks providers from adding services to the region that would increase access to care. These laws result in fewer services for patients. The Mercatus Center estimates that continuing COPN in Virginia could lead to approximately 10,800 fewer hospital beds, 41 fewer hospitals offering MRI services and 58 fewer hospitals offering CT scans. Reforming COPN will allow providers to offer more services and expand options to patients.
What are we waiting for?
In 2016, the Virginia General Assembly considered legislation that would have replaced the COPN program with a permit process. This would allow providers to offer services, as long as they met charity care requirements and quality standards. The House of Delegates passed this legislation. Unfortunately, it did not pass the Senate. Our efforts continue and we will be advocating for reform legislation in the 2017 legislative session.