What became clear is that of all the metrics we observed, the presence of certificate of need laws was the strongest correlation to how well-served a state is for ambulatory surgery.
New information presented here only strengthens that correlation.
CON laws are present in 35 states, though specifics vary. Some states —12, in fact — have laws that don’t regulate ASCs, which means that only 23 states, plus the District of Columbia, require ASCs to apply for a CON, while 27 states do not.
Of the 35 states with CON requirements, the 12 that don’t regulate ASCs tend to have more ASCs per capita. Mean per-capita ASC rates underscore the disparity.
States that require ASCs to apply for a CON have, on average, 1.57 ASCs per 100,000 residents. States with CON laws that don’t regulate ASCs have an average of 1.86 per 100,000 residents, while those with no CON law have an average of 1.96 ASCs per 100,000 residents.
Below are all 50 states, plus the District of Columbia, ranked by per-capita ASC rate.
Note: Blue highlight denotes that a state has no CON law. Green denotes states with CON laws that do not regulate ASCs, according to the National Conference of State Legislatures.
|
Rank |
State |
People per ASC |
ASCs per |
||
|---|---|---|---|---|---|
|
1 |
Maryland |
342 |
6,177,224 |
18,062 |
5.54 |
|
2 |
Georgia |
368 |
10,711,908 |
29,108 |
3.44 |
|
3 |
Wyoming |
18 |
576,851 |
32,047 |
3.12 |
|
4 |
Idaho |
55 |
1,839,106 |
33,438 |
2.99 |
|
5 |
New Jersey |
259 |
9,288,994 |
35,865 |
2.79 |
|
6 |
Arizona |
191 |
7,151,502 |
37,442 |
2.67 |
|
7 |
Mississippi |
77 |
2,961,279 |
38,458 |
2.60 |
|
8 |
Nebraska |
51 |
1,961,504 |
38,461 |
2.60 |
|
9 |
Nevada |
80 |
3,104,614 |
38,808 |
2.58 |
|
10 |
Alaska |
18 |
733,391 |
40,744 |
2.45 |
|
11 |
Washington |
187 |
7,705,281 |
41,205 |
2.43 |
|
12 |
Colorado |
134 |
5,773,714 |
43,087 |
2.32 |
|
13 |
Arkansas |
69 |
3,011,524 |
43,645 |
2.29 |
|
14 |
Kansas |
67 |
2,937,880 |
43,849 |
2.28 |
|
15 |
Delaware |
22 |
989,948 |
44,998 |
2.22 |
|
16 |
Oregon |
90 |
4,237,256 |
47,081 |
2.12 |
|
17 |
Florida |
457 |
21,538,187 |
47,130 |
2.12 |
|
18 |
California |
817 |
39,538,223 |
48,394 |
2.07 |
|
19 |
Tennessee |
138 |
6,910,840 |
50,079 |
2.00 |
|
20 |
New Hampshire |
27 |
1,377,529 |
51,020 |
1.96 |
|
21 |
Pennsylvania |
248 |
13,002,700 |
52,430 |
1.91 |
|
22 |
Indiana |
129 |
6,785,528 |
52,601 |
1.90 |
|
23 |
Louisiana |
86 |
4,657,757 |
54,160 |
1.85 |
|
24 |
Montana |
19 |
1,084,225 |
57,064 |
1.75 |
|
25 |
South Dakota |
15 |
886,667 |
59,111 |
1.69 |
|
26 |
North Dakota |
13 |
779,094 |
59,930 |
1.67 |
|
27 |
Missouri |
102 |
6,154,913 |
60,342 |
1.66 |
|
28 |
Ohio |
195 |
11,799,448 |
60,510 |
1.65 |
|
29 |
Texas |
442 |
29,145,505 |
65,940 |
1.52 |
|
30 |
Hawaii |
22 |
1,455,271 |
66,149 |
1.51 |
|
31 |
Connecticut |
53 |
3,605,944 |
68,037 |
1.47 |
|
32 |
Wisconsin |
85 |
5,893,718 |
69,338 |
1.44 |
|
33 |
Minnesota |
81 |
5,706,494 |
70,451 |
1.42 |
|
34 |
Utah |
45 |
3,271,616 |
72,703 |
1.38 |
|
35 |
South Carolina |
70 |
5,118,425 |
73,120 |
1.37 |
|
36 |
North Carolina |
129 |
10,439,388 |
80,925 |
1.24 |
|
37 |
Rhode Island |
13 |
1,097,379 |
84,414 |
1.18 |
|
38 |
Maine |
15 |
1,362,359 |
90,824 |
1.10 |
|
39 |
Michigan |
106 |
10,077,331 |
95,069 |
1.05 |
|
40 |
Illinois |
131 |
12,812,508 |
97,805 |
1.02 |
|
41 |
Oklahoma |
40 |
3,959,353 |
98,984 |
1.01 |
|
42 |
New Mexico |
20 |
2,117,522 |
105,876 |
0.94 |
|
43 |
Iowa |
29 |
3,190,369 |
110,013 |
0.91 |
|
44 |
Alabama |
41 |
5,024,279 |
122,543 |
0.82 |
|
45 |
Kentucky |
35 |
4,505,836 |
128,738 |
0.78 |
|
46 |
Massachusetts |
54 |
7,029,917 |
130,184 |
0.77 |
|
47 |
New York |
147 |
20,201,249 |
137,423 |
0.73 |
|
48 |
Virginia |
61 |
8,631,393 |
141,498 |
0.71 |
|
49 |
West Virginia |
8 |
1,793,716 |
224,215 |
0.45 |
|
50 |
District of Columbia |
3 |
689,545 |
229,848 |
0.44 |
|
51 |
Vermont |
2 |
643,077 |
321,539 |
0.31 |
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.