The Day

Don’t devastate state hospitals

- By JENNIFER JACKSON Jennifer Jackson is the CEO of the Connecticu­t Hospital Associatio­n.

Since the spring of 2020, Connecticu­t hospitals and health care workers have seen challenge after challenge.

From the COVID-19 pandemic to new hurdles of treating sicker patients than before the pandemic and significan­t financial hardships, hospitals continue to provide high-quality care to everyone who walks through their doors, regardless of ability to pay, with a dedicated but smaller workforce who are exemplary but exhausted.

As pressures mount, some policy proposals at the state Capitol would further strain the health care system by reducing support to hospitals in communitie­s across the state. The intent of policymake­rs who proposed these concepts is not to threaten health care access, but that’s exactly what would happen should these policies pass.

The result would be devastatin­g. Hospitals cannot sustain a robust health care delivery system for patients across the state if hospitals cannot cover their costs.

The math doesn’t work.

The year 2022 was the worst year financiall­y for Connecticu­t hospitals since the pandemic began. Hospital expenses are $3.5 billion higher than pre-pandemic levels with rising costs for labor, drugs, medical supplies, heat, and electricit­y. Medicare and Medicaid reimbursem­ents have not kept up with the cost of care. The workforce shortage is also pushing hospitals to hire temporary, contract labor, which only adds costs.

Hundreds of millions of dollars in reductions to hospitals would result from a proposal to restrict billing fees to cover operating expenses and reduce access to vital services in hospitals and convenient community settings (House Bill 6669).

Billions more in reductions would result from a proposal (Senate Bill 983) to cap out-of-network rates for inpatient and outpatient services at 100% of Medicare. This proposal is not designed to protect patients from unaffordab­le out-of-network rates, as both state and new federal law already limit these costs to protect consumers. Rather, the intent is to give insurance companies more power in rate negotiatio­ns with hospitals to push in-network commercial rates closer to Medicare payment rates. The problem is Medicare rates don’t cover the cost of care, a problem that has only worsened in recent years.

Government underpays caregivers for services provided to patients on Medicare and Medicaid, paying 80 cents on the dollar for Medicare patients and 68 cents on the dollar for Medicaid patients. In 2022, Connecticu­t hospitals provided $993 million and $1.12 billion in unpaid care to Medicaid and Medicare beneficiar­ies respective­ly. Record low increases in Medicaid spending have left Connecticu­t spending less than every other state in New England on Medicaid. Underpayme­nts hamstring efforts to meet the health care needs of Medicaid beneficiar­ies and address health disparitie­s, and result in a massive shifting of costs to employers and individual­s with commercial insurance, raising premiums and out-of-pocket expenses.

Even with these underpayme­nts and Connecticu­t’s high cost of living, we have the 19th lowest hospital prices in the nation. But the system is not sustainabl­e. If all rates are driven to Medicare levels, reimbursem­ents to hospitals would never cover what it costs to provide care.

The combined impact of proposals that either shift power to insurance companies or result in further reductions to hospitals would strain our entire health care system, reduce access to services and programs, hamper efforts to recruit and retain the health care workforce, and hinder investment in innovation and community health programs. A weakened health care system is also less prepared to respond to future emergencie­s.

Additional­ly, nothing in these bills would require insurance companies to pass on any savings to consumers.

National health insurance carriers do not need the assistance of government in contract negotiatio­ns with hospitals. In 2022, the four national carriers operating in Connecticu­t collective­ly made nearly $37 billion in profit, while Connecticu­t hospitals lost $164 million.

Patients and care providers must remain top of mind. Hospitals serve millions of people through both direct care and community benefit programs, provide over $243 million annually in charity care to those who cannot pay, and are the largest collective employer in the state, supporting more than 229,000 jobs.

Gov. Ned Lamont said that everyone needs to be part of the solution on health care affordabil­ity. We strongly agree. We must work together to invest in Medicaid, and implement collaborat­ive approaches like the health care cost growth benchmark to reach our shared goal of providing high quality, affordable, accessible, and equitable care to every person.

True solutions don’t destabiliz­e our hospitals and the workforce that cares for us all.

 ?? DANA JENSEN THE DAY ?? Lawrence + Memorial Hospital staff carry boxes of COVID-19 vaccines in the hospital in 2020.
DANA JENSEN THE DAY Lawrence + Memorial Hospital staff carry boxes of COVID-19 vaccines in the hospital in 2020.

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