Regulation, fiscal pressure expand CEO planning role

In an environment of strict fiscal control and continuing pressure to control costs, many CEOs are becoming actively involved in health planning at the local level. Most experts agree that regulators aren't likely to bring back certificate of need as the basis of a formalized planning system. But some regulators are taking a second look at direct fiscal controls that have helped contain costs in some eastern states. The specter of some form of regulation, coupled with mounting financial problems, is prompting health care executives to take a close look at what has worked in health planning and what has been a disaster. Moreover, some CEOs aren't waiting for the bureaucracy to inch along. They are working with other executives to sort out community needs and solve areawide health delivery problems.