Empowering Health Care Consumers



Funding Area

Empowering Health Care Consumers


May 22, 2018


This report by MergerWatch, supported by NYHealth, offers an analysis of New York State’s Certificate of Need (CON) process, which provides oversight of hospital transactions, and how it can be modernized for increased consumer engagement.

Hospitals are consolidating at a rapid pace, merging into mega-systems, downsizing, and even closing facilities. Consolidation in the health care provider market can reduce competition and consumer choice, lead to cuts in services, and foster higher prices. The issue is typically debated by health care industry stakeholders and anti-trust monitors, with limited channels for consumer input. As the hospital landscape changes, affected communities and consumers should have a voice in decision-making processes about the future of their local hospitals.

The report includes case studies in New York State and best practices from other states. Drawing from interviews with consumer advocates, New York State residents in communities affected by hospital consolidation, and key stakeholders and policymakers, MergerWatch has developed a set of policy and process recommendations to improve the transparency of New York’s CON process, as well as enhance consumer engagement and preserve access to care.

Key recommendations include:

  • Ensure that consumers affected by hospital closures or elimination of key hospital services are notified and engaged.
  • Improve transparency, consumer engagement, and accountability when health systems propose takeovers of community hospitals.
  • Increase consumer representation on State CON review boards and increase consumer engagement in the CON process.
  • Ensure CON-approved projects preserve access to timely, affordable care and advance local and State health-planning goals.

Read the full report.

Read the executive summary.