Certificate of Need
What the new State Medical Facilities Plan means for 2026
The annual plan reshapes which projects are reviewable. Here is how to read this year's need determinations before you file.
Read insightHealthcare planning · Strategy · Certificate of Need · Since 1979
Clarity for the decisions that have to hold up.
PDA helps hospitals, health systems, providers, and government agencies turn complex regulatory, market, and facility challenges into plans that win approval — and stand up to scrutiny.
350+
Certificate of Need applications
87%
CON approval rate
$1B+
In project value represented
45+
Years of healthcare practice
The PDA approach
Take a problem, and make it a feature.
It has guided our work since 1979. A regulatory hurdle becomes the argument that wins. A constrained site becomes a smarter facility plan. A crowded market becomes a defensible position.
We are a healthcare planning and management consulting firm — strategists, market researchers, regulatory specialists, and facility planners who work where the path forward is complex, expensive, and high-stakes. Our job is to give leaders a plan they can act on, defend, and trust.
By the numbers
Experience that brings clarity to high-stakes decisions.
- $1B+In total project value represented through Certificate of Need applications.
- 350+CON applications prepared and submitted across the country.
- 87%Approval rate — well above the field, on the decisions that matter most.
- 45+Years guiding strategy for hospitals, providers, and the public sector.
Multi-state Certificate of Need experience
CON regimes differ state to state. We have prepared and defended applications in regulated markets across the country — and we know how each one reads an argument.
- North Carolina
- Connecticut
- Delaware
- Florida
- Georgia
- Maryland
- Oregon
- South Carolina
- Utah
- West Virginia
What we do
Consulting built for healthcare complexity.
Six practices that work together — from the boardroom strategy to the regulatory filing to the facility that gets built.
- 01
Strategic Planning
Market assessments, demand forecasting, service-line strategy, feasibility studies, scenario modeling, and board retreats that align leadership around a direction.
— learn more about Strategic Planning - 02
Certificate of Need
Application strategy, market and financial forecasts, competitive analysis, public-support strategy, litigation support, and state health plan petitions.
— learn more about Certificate of Need - 03
Market Research & Community Health
GIS market mapping, demographic and epidemiological research, benchmarking, community health assessments, and service-integration planning.
— learn more about Market Research & Community Health - 04
Facility & Capital Planning
Master facility planning, space programming, capital asset planning, surgery and central-sterile planning, and ambulatory care design support.
— learn more about Facility & Capital Planning - 05
Primary & Ambulatory Care
Access strategy, ambulatory network planning, rural health clinic development, and primary care capacity modeling for growing and underserved markets.
— learn more about Primary & Ambulatory Care - 06
Government & Public Sector
Healthcare planning, policy research, analytics, facilitation, and management consulting for federal, state, and local agencies — including VA experience.
— learn more about Government & Public Sector
How we work
From uncertainty to a defensible plan.
- 01 / Assess
Understand the field
Market, community, competitors, regulatory environment, and organizational goals — mapped before a single recommendation is made.
- 02 / Model
Run the numbers
Demand forecasts, financial models, GIS maps, and stakeholder input turn open questions into a short list of viable, evidence-backed options.
- 03 / Plan
Build the argument
A strategy, application, or facility plan — structured so the logic is clear and the conclusion is hard to argue with.
- 04 / Defend
Make it hold
We help leaders communicate, defend, and adapt the plan — through approval, public comment, litigation, and execution.
Certificate of Need
A regulatory practice with a track record.
Few decisions in healthcare carry the cost and scrutiny of a Certificate of Need. We have spent decades on the strategy, the forecasts, the competitive case, and the defense — across ten states and counting.
Explore our CON practice- 350+Applications submitted
- 87%Approval rate
- $1B+Project value
- 10States of experience
Who we serve
The full healthcare ecosystem.
From rural community hospitals to academic systems to government agencies — we plan for organizations of every size and structure.
- 01
Hospitals & Health Systems
- 02
Rural & Community Hospitals
- 03
Physician & Primary Care Groups
- 04
Diagnostic & Imaging Centers
- 05
Senior Care & Post-Acute
- 06
Behavioral Health
- 07
Surgery & Ambulatory Care
- 08
Government & Public Sector
Insights
View all insights Reading the regulatory landscape.
- Rural Health
Planning access where the market won't build it
Rural service-line decisions don't follow urban math. A framework for sizing demand and making the case for care closer to home.
Read insight - Strategy
Service-line strategy when capital is tight
How systems are sequencing investments, defending margin, and choosing which lines to grow when every dollar is contested.
Read insight
Let's talk
Turn a complex healthcare challenge into a clear plan.
Whether you're weighing a new service line, preparing a Certificate of Need, planning a facility investment, or aligning leadership on direction — we can help you see the path forward.
Schedule a consultation