Washington state hospitals face stricter state controls over partnerships

As of last week, hospitals operating in Washington state face new requirements to obtain a Certificate of Need from the state before affiliating with other hospitals. In addition, they must disclose their policies on admissions, nondiscrimination, end-of-life care and reproductive health care to the state.

These types of legal and regulatory changes may look increasingly attractive to local municipalities and state governments concerned about unintended consequences of the current consolidation trend in health care. In Washington state, the change in the law grew out of public concern about access to contraceptive and end-of-life care when secular hospitals are acquired by Catholic health systems.

However, opponents of the law say it hinders hospitals from making decisions that may ultimately improve care and lower costs in the communities they serve, while simultaneously burdening them with increased administrative tasks that do little to aid patients in assessing hospital services and their individual access to care.

“Publicly posted policies on admissions, nondiscrimination, end-of-life care and reproductive health care] aren’t predictive of services. It’s not great patient information because also services can change,” Mary Kay Clunies-Ross, a spokeswoman for the Washington State Hospital Association, told the Puget Sound Business Journal. “A policy may permit it but an individual physician may not want to participate. So for a patient, the policy doesn’t give them all the information they need.”

The Washington State Hospital Association is currently suing the state to stop the Certificate of Need requirement in the law from extending to affiliations and partnerships. It argues that the Certificate of Need program basically amounts to a permitting process that typically costs $40,000 and takes months or years to complete. Expanding it now to looser affiliations and partnerships between hospitals is an arbitrary change that fixes a problem that doesn’t really exist, the Association noted.