Healthcare Design Knowledge Community

Certificate of Need in the Competitive Healthcare Market

Written by Fady Barmada | Mar 04, 2016

With limited resources and burgeoning cost structures, the success of a healthcare project is increasingly determined by the degree of clinical program and scope alignment with established community health needs.

A Certificate of Need (CON) is a mechanism that helps drive that alignment. The CON verifies the requisite program and scope for construction, renovation and/or necessity of specialized medical equipment. Creating projects that align with the needs of their users, while stabilizing costs and services, helps avoid an inflated healthcare system. With the healthcare industry shifting from a quantity-driven practice to a quality-driven practice, healthcare planning must adapt as well.

Infusing the values and methodology of Lean thinking, we approach projects with the idea of building only what is necessary; delivering results that exceed expectations without exceeding budgets, schedules, materials or resources. Our approach parallels the CON submission process by establishing the intent and scope of healthcare initiatives defined not only by our clients, but also by the community they serve.

The complex CON process undertaken for Health & Hospitals Corporation on the Henry J. Carter Specialty Hospital and Nursing Facility in Harlem required a detailed submission as well as continuous communication with the Department of Health and deciphering state requirements. Submitting a successful CON requires constant and continuous collaboration with the entire team and with the owner to ensure a clear and practical end-goal is established. Together, the client, contractor and design team review every package of the project before submission to guarantee the expectations and intentions of the project respond to the needs of the community and to DOH requirements. With the Henry J. Carter project, our client was instrumental to the success of the submission, making quick decisions, clarifying operational intent and identifying projected capacity improvement.

With a dedicated Asset Advisor on our team, we provide financial advisory services on a strategic level. This includes evaluating the potential for alternative project financing structures and project delivery methodologies, identifying optimization opportunities within a portfolio of physical assets, projecting the business impact of various development strategies and balancing the needs of the institution with the needs of the community. Any project undertaken by a health system should create value; not only for the health system but also for the populations they serve.