REGULATORY REVIEW
Many in the ASC community believe that the newly proposed DoN requirements were introduced in response to the recent closures of two community hospitals in Massachusetts.”
—Nawa Arsala, ASCA
CON laws “impede the efficient perfor- mance of health care markets” and “cre- ate barriers to entry and expansion to the detriment of health care competition and consumers.” The agencies stated that they support the repeal of such laws. Since then, the Federal Trade Commis- sion has publicly opposed such laws in Virginia, North Carolina, Alaska, Geor- gia, Hawaii and other states. The difference in DoN laws in other
states and the case at hand is that Mas- sachusetts’ proposed regulations give the regulating power to the acute-care hospitals, not the state. DoN laws in
other states require the state to plan and regulate the market, rather than private actors that would otherwise compete with the providers they would be regulating. There are legitimate instances in which the state should reg- ulate the health care market to prevent oversaturation. Economists and legis- lators agree, however, the state is not the regulator here. The Massachusetts Association
of Ambulatory Surgery Centers (MAASC) believes that evidence sug- gests that increases in market con- solidation might be associated with
decreased quality. The Massachusetts Health Policy Commission also cites this argument and refers to a 2006 study on market consolidation shows that hospital concentration reduces quality. “The actions of the Depart- ment of Public Health are not only disappointing to MAASC but also contrary to the goals of the Common- wealth,” says Greg DeConciliis, pres- ident of MAASC. “For the past two years, Massachusetts has failed to meet its health care cost benchmarks. One reason for that is high outpa- tient care costs. ASCs are a part of the solution, not the problem.” Final regulations were targeted for release in early 2017.
Nawa Arsala is ASCA’s assistant regu- latory counsel. Write her at narsala@
ascassociation.org.
22 ASC FOCUS JANUARY 2017
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