The Connecticut Hospital Association (CHA) has suspended the Office of Health Strategies’ (OHS) ongoing cost increase benchmarking process and recent policy recommendations, citing data discrepancies, financial burdens, and oversight of advice from medical experts. continues to sound the alarm on the issue.
Earlier this week they wrote: letter I outlined my concerns to members of the Public Health, Insurance and Real Estate committees.
CHA said OHS made the suggestion. recommendation Implementing performance improvement plans (PIPs) for entities that fail to meet benchmarks and imposing civil penalties on companies that fail to submit PIPs when required. CHA argues that taking such action would be premature and inappropriate given ongoing data issues.
An OHS spokesperson said benchmarking is an important tool for slowing growth in health spending.
“High medical costs in CT create a barrier to patient access and place a financial burden on consumers,” an OHS spokesperson said. “The recommendations in our report come from several sources, including: Hearing on cost increase benchmarks, of Information hearing The meeting, hosted by the CT Department of Insurance, will include discussions with benchmark public hearing participants, Benchmark Steering Committee members, other benchmark states, community organizations, advocates, and other stakeholders, including members of the CT General Assembly. Follow up. OHS has therefore made a range of recommendations aimed at addressing the complex nature of high healthcare costs. ”
Sen. Jorge Cabrera (D-Hampden), Co-Chairman of the Insurance and Real Estate Committee, said the Insurance and Real Estate Committee is working hard to ensure affordable health insurance and health care and is committed to the process. He said bringing some accountability and transparency to the issue would help.
He said he wanted to ensure that the standard for cost increases was maintained, as costs were currently higher than inflation, hurting people with private insurance. Cabrera added that he is also concerned about the degree of consolidation among hospital networks like Hartford HealthCare and Yale-New Haven, which divide the state almost evenly.
Another OHS recommendation is the establishment of out-of-network price caps to alleviate market pressures from insurers refusing to join insurer networks.
CHA warned in the letter that mandating price caps for out-of-network services could result in billions of dollars in savings for local hospitals. Such a move, coupled with the continued financial burden highlighted in the CHA’s report on the impact of the pandemic, could put health care delivery at risk. Both the CHA and OHS reports for fiscal year 2022 confirm growing financial distress, with hospital costs exceeding revenue, resulting in negative operating margins.
CHA also highlighted that the current Certificate of Need (CON) program required for service changes is riddled with administrative and bureaucratic barriers that impede the delivery of the highest level of care. The group says delays in reviewing applications and a lack of financial oversight in the decision-making process are exacerbating health care costs.
CHA is calling for legislative efforts to streamline the CON process, reduce unnecessary costs, ensure equal compliance and application of the rules, and reduce regulatory burden.
“High healthcare costs are a crisis. We continue to work with hospitals and other partners to reduce the cost of care for all residents,” the OHS spokesperson added.
Meanwhile, as hospitals shoulder increased costs for providing uncompensated care and grapple with inadequate Medicare and Medicaid reimbursement, CHA is asking OHS to reconsider its recommendations.
