============================================================================== CERTIFICATE OF NEED INTELLIGENCE BRIEF: DELAWARE The Rojas Report | conlaws.rojasreport.com/states/delaware/ ============================================================================== State: Delaware (DE) Score: 45/100 Tier: Moderate Rank: 23 of 51 jurisdictions ------------------------------------------------------------------------------ KEY METRICS ------------------------------------------------------------------------------ 6+ Services regulated by CON 1978 Year CON enacted ~60% ChristianaCare market share 3 Counties in entire state ------------------------------------------------------------------------------ SUMMARY ------------------------------------------------------------------------------ Delaware CON score 45/100 (moderate). Limited CON program covering nursing facilities, hospitals, and select services since 1978. ChristianaCare dominates the state's healthcare market. ------------------------------------------------------------------------------ SCOPE OF REGULATION ------------------------------------------------------------------------------ * Services Requiring CON Approval * RWJBarnabas Health's $7.5B empire. 25+ regulated services. Score: 100/100. ------------------------------------------------------------------------------ APPLICATION PROCESS ------------------------------------------------------------------------------ Applications are reviewed by the Delaware Health Resources Board. The process includes a public hearing where interested parties — including competitors — can testify for or against the application. ------------------------------------------------------------------------------ MARKET CONCENTRATION ------------------------------------------------------------------------------ The state's proximity to Philadelphia means that some Delaware residents seek care across state lines, which partially mitigates the domestic concentration. But for the majority of Delawareans — particularly those in Kent and Sussex counties — the local market is the only practical option. Delaware's CON program is moderate by national standards, but that is grading on a curve. In a state with three counties and two dominant hospital systems, even a moderate regulatory barrier locks in the existing market structure. ============================================================================== Source: The Rojas Report | conlaws.rojasreport.com/states/delaware/ Data: Cicero Institute, NASHP, FTC, DOJ, CMS, state health departments Generated: April 2026 ==============================================================================