Connecticut has rural hospitals but no Rural Health Plans.
Connecticut is one of only five states which has no federally approved rural health plan. In consequence, there is no organized effort at the state level to preserve or enhance rural health services. This may prevent rural Connecticut hospitals from accessing Farm Bureau funds, from converting to critical access hospitals, or taking advantage of other federal programs intended to support rural health.
When labor and delivery services in rural hospitals are threatened, the state’s response is ad hoc.
Attorney General William Tong has made significant efforts to highlight this problem, although he holds back from addressing “charitable” foundations which are charged with preserving rural hospitals.
Comptroller Sean Scanlon shows promise of having an interest in this area, although the comptroller’s office is a contributor to the problem, falling into the trap of “narrow hospital networks” for state employees.
A special interest group convinced the Gov. Ned Lamont that “freestanding birthing centers” would fill the gap, but neglected to tell the governor that even newly licensed birthing centers need nearby hospital backup. Without such backup, women might as well be delivering at home. The new licensing is good news for the birthing centers, and their ability to be paid by health plans, but is only of help in urban areas.
This leaves the fate of rural hospitals (Windham, owned by Hartford Health; Johnson Memorial by Trinity/St. Francis; Sharon by Nuvance/Danbury) in the hands of entrepreneurs, not all of whom merit the millions they are paid. When they falter, lacking imagination, closing down is the default setting.
Only the little-known Office of Health Strategy (OHS) in the Department of Health is carrying the water for rural areas. They have just issued a decision which may tip the balance in favor of rural health services, but now will need politicians to back them up. Powerful lobbies and law firms are certain to appeal the new OHS decision to prevent closing services at Sharon.
First, the governor should recognize the difficult and hard work of OHS, and commend their attention to citizen input.
Second, the attorney general should take another look at an area foundation, established under his predecessor, which was intended to be a backup, or safety valve, in the event a dodgy for-profit, then acquiring Sharon, gave it up.
Finally, the comptroller should take a look at the pricing strategies of commercial health insurers serving state employees. Health insurers think they are saving money in creating narrow or limited networks of hospitals and physicians. By “preferring” the use of larger hospitals, calling them “centers of excellence,” for example, and reducing copayments for enrollees whose choose those hospitals, the health insurers siphon admissions (and births) away from community hospitals, and into larger urban “must have in the network” hospitals.
The net result is that a birth which might have taken place at Sharon at a lower price now takes place at a larger hospital, at a higher price. A study prepared for submission to the state will demonstrate this, using the new “transparency” in hospital prices and insurer payments emerging from federal legislation.
OHS has listened to consumers and residents and has stuck its neck out. Let’s see political leaders in the State of Connecticut back them up, at least until we have a rural health plan that preserves hospital level services in place.
Deborah Moore lives in Sharon.