The Verdict

Rhode Island

Rhode Island's long-standing and expansive Certificate of Need program creates significant barriers to entry, protecting incumbent health systems and limiting consumer choice. The state's healthcare market is highly concentrated, with a few dominant players.

Highly Restrictive

80/100

1970

18

3

Dan McKee (D)

What CON Covers

What Services Require a CON?

  • Hospitals & Nursing Homes
  • Inpatient Rehabilitation Centers
  • Freestanding Surgical Facilities (ASCs)
  • Home Care & Hospice Agencies
  • Bed Expansions (>10 beds or 10%)
  • Cardiac Catheterization & Open-Heart Surgery
  • Organ Transplant Services
  • PET, MRI, and Linear Accelerators
  • New services with >$1.7M annual operating cost
  • Capital expenditures >$5.9M

The Application Gauntlet

Reviewing AgencyDept. of Health, Health Services Council
Application Fee$500 - $10,000 + 0.25% of project cost
Application Timeline120 days (reviews twice per year)
Competitor InterventionYes, explicitly allowed

Who Benefits

Hospital Market Concentration

The hospital market is an oligopoly, with Lifespan (Brown University Health) and Care New England controlling ~80% of acute-care beds.

Insurer Market Concentration

BCBS of Rhode Island dominates the commercial market with a staggering 76% share in the large-group market.

Dominant Systems

Lifespan, Care New England, and CharterCARE are the three largest systems, controlling the majority of inpatient volume.

The Human Cost

Case Study: Encompass Health Denied

In 2021, a proposal by Encompass Health to build a new 50-bed inpatient rehab hospital was overturned on appeal from existing providers. The stated reason was a lack of public need, effectively protecting incumbent hospitals from new competition and forcing patients to rely on existing, potentially overburdened, facilities.

Reform Status

Rhode Island's CON law has been amended over 25 times but never fully repealed. A 2026 bill to repeal the statutes was introduced but has not passed, indicating that significant reform is not on the immediate horizon. The state remains committed to its CON regime, with periodic adjustments rather than a fundamental overhaul.

05Editorial

The Rojas Report Take

Rhode Island's healthcare landscape is a textbook example of regulatory capture. For over half a century, the state's Certificate of Need law has acted as a fortress, shielding a handful of powerful hospital systems from meaningful competition. With three systems controlling the vast majority of inpatient care and one insurer holding a near-monopolistic 76% of the large-group market, the deck is stacked against new entrants and, ultimately, against patients. The denial of Encompass Health's new rehabilitation hospital, explicitly to prevent 'cannibalizing' the existing system, says it all: in Rhode Island, the health of the incumbents is prioritized over the health of the market. It's a closed loop of entrenched interests, and Rhode Islanders are paying the price.

The Rojas Report

Related Content

Sources: RI Dept. of Health, RI General Laws, and public records.