Glossary
Healthcare planning glossary.
Plain-language definitions of the terms that come up most in Certificate of Need work, community health planning, and healthcare strategy.
- Certificate of Need (CON)
- A state approval a healthcare provider must obtain before building a facility, adding beds, buying major medical equipment, or launching certain services. Roughly three dozen states operate CON programs. Approval requires proving the project is needed in the community and consistent with the state's health plan.
- State Medical Facilities Plan (SMFP)
- An annual (or biennial) planning document some states publish that identifies statewide need for regulated services by county or region and sets the policies the CON agency applies. In North Carolina and similar states, the SMFP is the starting point for any CON strategy.
- Need determination
- A finding by the state — usually in an SMFP or a comparable planning document — that a specified number of beds, equipment units, or service capacity is needed in a defined geographic area. It defines the size of the opportunity applicants may compete for.
- Review threshold
- The statutory dollar amount, bed count, or equipment category above which a proposed project becomes subject to CON review. Thresholds vary widely by state and are adjusted periodically for inflation or by legislative action.
- Reviewable service
- A category of healthcare service — such as acute-care beds, ORs, MRI, cardiac catheterization, dialysis, or long-term care — that a state has designated as subject to CON review. What is reviewable and non-reviewable differs materially by state.
- Competing application
- A CON application filed by another provider in the same batch cycle or geographic area, seeking to fill the same need pool. Competing filings trigger comparative review, where the state chooses among applicants based on statutory criteria.
- Moratorium
- A temporary suspension — imposed by statute or agency rule — on new CON applications for a specific service or category. Moratoria are used to control growth in categories the state has determined are adequately supplied.
- Community Health Needs Assessment (CHNA)
- A structured study of a community's health status, needs, and access gaps, combining demographic, epidemiological, and stakeholder data. IRS rules require nonprofit hospitals to complete a CHNA every three years and adopt an implementation strategy from it.
- Service line
- A grouping of clinical services organized around a patient population or condition — cardiovascular, oncology, orthopedics, women's, behavioral health — used by health systems for strategic planning, investment, and performance management.
- Catchment area
- The geographic area from which a facility or service line draws the majority of its patients, typically defined by ZIP code, drive time, or discharge origin. Catchment analysis is foundational to both strategic planning and CON need methodology.
- Ambulatory Surgery Center (ASC)
- A freestanding facility licensed to perform surgical procedures on an outpatient basis. ASCs are CON-reviewable in some states and deregulated in others; their growth has reshaped the economics of hospital-based surgery.
- Certificate of Public Advantage (COPA)
- A state-issued approval that immunizes an otherwise antitrust-sensitive hospital or health-system combination from federal antitrust enforcement in exchange for ongoing state supervision. Distinct from a CON, but often part of the same regulatory conversation.
- State Medical Facilities Plan petition
- A formal request that a state's planning agency add, adjust, or reallocate a need determination in the upcoming SMFP. Petitions are a key strategic tool used ahead of a filing to reshape the batch a project will be reviewed in.
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