Everyone should have access to high-quality healthcare, and cost should never be a barrier to that care.
To achieve this fundamental objective, we need continued local and national collaboration to support care delivery, and we also must be cautious of policies proposed in Washington and positioned as ways to reduce costs that would in reality jeopardize access to care.
Connecticut hospitals and health systems work to not only deliver high-quality, equitable care, but to increase access to that care. They provide care to anyone who walks through their doors, regardless of their ability to pay. No one is turned away because they are uninsured, underinsured as a result of flawed insurance products with astronomical deductibles, or covered by Medicaid.
Connecticut also leads the nation in financial assistance programs and protections against medical debt. Local hospitals work hard to make sure patients know about their financial assistance policies, connect uninsured patients to coverage, and advocate for policies to prevent medical debt in the first place.
Inability to pay for services should not deter anyone from seeking needed medical care. More must be done to support hospitals’ work to address rising healthcare costs — driven by factors like inflation and skyrocketing costs of drugs and labor — and improve access, equity, and affordability.
But so-called “site-neutral” policies being discussed in Washington, including provisions in the FAIR Act and the SITE Act, would not achieve this goal. These proposals would not mitigate medical debt or increase the quality of care. Rather, they would further decrease government payments to local hospitals, which are only paid 74 cents for every dollar of care provided to Medicare patients and even less for Medicaid patients, potentially endangering hospitals’ ability to provide life-saving care for the thousands of patients who rely on 24/7 access to vital services.
While these federal proposals have at times been raised with the best intentions and positioned as ways to achieve shared goals, in reality they can have a harmful effect on healthcare access and equity.
“Site-neutral” policies ignore the fundamental differences between hospitals and other sites of care that affect the cost of delivering outpatient services, including that hospitals are equipped to serve sicker patients and offer emergency care to everyone, regardless of ability to pay. As hospitals focus more on whole-person care, population health, and preventive care to keep people healthy and out of the hospital, more services are being offered by hospitals in off-campus settings that increase convenience and access for patients. Hospital outpatient departments also support more Medicaid, low-income, and complex patients who may not be served by independent physicians, thereby significantly increasing access for patients who have difficulty obtaining healthcare elsewhere.
Connecticut hospitals are working with community partners, patients, and state leaders to make healthcare more affordable, accessible, and equitable — even as they face enormous financial headwinds. They are working to move beyond solely providing care when people are sick and focusing on improving the health of individuals and their communities to prevent disease in the first place.
Connecticut also has some of the strongest patient protections in the nation when it comes to surprise billing and banning practices such as medical liens on property. Hospitals strive to offer clear and meaningful pricing information, patient resources to assist in the bill payment process, and free and discounted care for uninsured individuals.
Many hospitals go well beyond statutory requirements extending discounts to individuals whose income is up to 550% of the Federal Poverty Line and offering assistance to the underinsured. If a patient can’t afford a bill because they have a high deductible plan or their personal situation changes, hospitals have help available. In total, Connecticut hospitals provided over $130 million in charity care through these efforts in 2022.
Connecticut hospitals are committed to improving health and health equity in our communities, which requires a persistent focus on removing barriers to care — including barriers related to cost.
We must continue to take a collaborative approach to develop solutions that will work for Connecticut patients and families, and that are shaped not by national political think tanks, but by local stakeholders and our communities, with all voices at the table.
Mark Schaefer is Vice President, System Innovation and Financing, at the Connecticut Hospital Association.