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A Case 5.1: CON For Open Heart Surgery

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Read Activity 5.1: CON for Open Heart Surgery beginning on page 87 of the Harris text. Assuming that Jackson County Hospital decided to appeal the state's initial decision on the CON application, what arguments should the Hospital make as part of its appeal to get the initial determination reversed?

A certificate of need (CON), is a legal document required for proposed acquisitions, expansions, or creations of facilities are allowed. CONs are issued by a regulatory agency. The concept was developed in the 1970’s with concept of reducing healthcare costs and prevent unneeded cost due competition that may create inflated prices in the marketplace. The original CON concept was embraced by many states due to increased funding by the federal government. Over the years with increasing criticism many states have repelled CON laws. Criticisms of the CON process have been that it eliminates competition and may favor larger institutions and contribute to monopolization of the healthcare services in a particular community. The rejection of the Jackson County Hospital request for the CON for the open heart …show more content…
This is very serious type of heart attack during which one of the heart’s major arteries blocked. The time between “door and balloon time” is recommended to be 90 minutes for best outcomes. Without a functional heart program and full catheter capabilities for this type of event cannot be treated at the Jackson County Hospital. Therefore, requiring the patient to be transferred. Under these circumstance a patient with this life threatening STEMI would not have a 90 minute “door to balloon time” and will have poorer outcomes. This clearly is discriminatory against the at risk population.This is contrary to the stipulations in Section 1557 of the ACA and would be the basis for the appeal of the decision for the open heart program of the Jackson County

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