Certificate of need (CON) is a state law that requires healthcare providers to get approval before building new facilities, expanding services, or purchasing certain equipment. These laws are meant to control healthcare costs and prevent unnecessary duplication of services.

Key Takeaways

  • State approval required for certain healthcare expansions
  • Applies to facilities, services, and equipment
  • Intended to control costs and limit overbuilding
  • Can affect access to care and competition

How do certificate of need laws work?

Under certificate of need laws, healthcare providers must apply to the state and show that there is a need for a new facility, service, or piece of equipment before moving forward.

This process is intended to prevent oversupply, but it can also limit when and where new providers can enter the market. This drives down competition that could lower costs for consumers.

How do certificate of need laws affect you?

Certificate of need laws can affect both access to care and the cost of services. In some cases, they may limit the availability of certain services or reduce competition between providers.

These factors can influence broader healthcare costs, depending on how care is delivered and where services are available.

What this means in North Carolina

In North Carolina, certificate of need laws are a major focus of policy debate around healthcare costs and access. Lawmakers and advocates continue to evaluate whether these laws limit competition and keep costs high. Learn more about ongoing efforts around certificate of need reform.

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About the Affordable Healthcare Coalition of North Carolina

The Affordable Healthcare Coalition of North Carolina is a non-profit, non-partisan grassroots organization committed to supporting policies and efforts that will lower healthcare costs for families and business in North Carolina. We keep individuals informed on what is happening in North Carolina that impacts their healthcare costs, and advocate for policies that will make quality healthcare more affordable for individuals and businesses in North Carolina.

Published on:
July 28, 2026

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