Connecticut Hospitals Question OHS Referral Process, Policy Recommendations | Addicted to CT News

The Connecticut Hospital Association (CHA) continues to sound the alarm on ongoing issues with the Office of Health Strategy’s (OHS) cost growth benchmark process and recent policy recommendations, citing data inconsistencies, financial strain and neglected advice from medical professionals.

Earlier this week, they wrote a letter to lawmakers on the Public Health, Insurance and Real Estate committees expressing their concerns.

CHA said OHS made a recommendation to implement performance improvement plans (PIPs) for entities that fail to meet the criteria, and civil penalties for those that fail to file PIPs when doing so. is required. The CHA maintains that the introduction of such measures is premature and inappropriate, given current data challenges.

An OHS spokesperson said benchmarking is an important tool for slowing the growth of health care costs.

The high costs of health care in CT pose a barrier to patient access and a financial burden on the consumer, an OHS spokesperson said. Our report’s recommendations come from several sources, including the baseline hearing on cost growth, the informational hearing held by the CT Insurance Department, follow-up discussions with hearing participants in reference, members of the reference steering committee, other reference States and other stakeholders, including community organizations. , lawyers and members of the CT General Assembly. As such, OHS has developed a diverse set of recommendations aimed at addressing the complex nature of high health care costs.

Sen. Jorge Cabrera, D-Hamden, who co-chairs the Insurance and Real Estate Committee, said they are working hard to ensure that health insurance and health care are affordable and that providing some accountability and transparency to the process would be helpful.

He said they want to make sure the cost growth benchmark is maintained because, at the moment, it is higher than inflation and hurts people with private insurance. Cabrera added that they are also concerned about the degree of consolidation between hospital networks like Hartford Healthcare and Yale New Haven, which have divided the state fairly evenly.

Another OHS recommendation is to implement out-of-network price caps to reduce market pressure from providers who refuse to participate in insurer networks.

CHA warned in the letter that requiring price caps on out-of-network services could result in billions of dollars in cuts for local hospitals. Such a move, coupled with the current financial pressure highlighted by the CHA’s report on the impact of the pandemic, could jeopardize health care delivery. The CHA and OHS reports for fiscal 2022 corroborated growing financial distress, with hospital expenses outpacing revenue, resulting in negative operating margins.

CHA also highlighted that the current Certificate of Need (CON) program, required for any changes in services, is fraught with administrative and bureaucratic hurdles that hinder the delivery of top-notch healthcare. The organization says delays in reviewing applications and a lack of financial oversight in decision-making processes exacerbate health care costs.

CHA calls for legislative efforts to streamline the CON process, eliminate unnecessary costs, ensure compliance with rules and equality in their enforcement, and ease regulatory burdens.

The high cost of health care is a crisis. We will continue to work with hospitals and other partners to reduce the cost of care for all our residents, added an OHS spokesperson.

Meanwhile, as hospitals incur increased costs for providing uncompensated care and struggle with inadequate Medicare and Medicaid reimbursements, CHA is asking OHS to reconsider its recommendations.