What is the primary purpose of the Certificate of Need (CON) program in health care?

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Certificate of Need programs are about managing health-care capacity and costs by requiring state approval before major capital changes like building a new hospital, expanding beds, or adding substantial services. The goal is to ensure that proposed projects meet real community needs, avoid duplicating existing services, and are financially viable, so that spending is controlled and patient access remains stable. A state CON board or similar agency reviews factors such as anticipated demand, current capacity, and the impact on access and quality before approving or denying a project. This focus explains why it’s not about staffing ratios, physician licensure, or device approvals—those duties lie with other bodies (licensure through medical boards, device approvals through the FDA, and staffing guidelines through separate regulations and accreditation).