Health Insurance

Hospitals and health systems are committed to ensuring timely patient access to medically necessary healthcare services. Access to coverage is critically important and is why Connecticut hospitals and health systems have long advocated for policies that increase access to coverage — including affordable commercial health insurance and sustainable Medicare and Medicaid programs.

Patients should be able to rely on their health insurance plans to facilitate covered, medically necessary healthcare services when they need it without delays or inappropriate denials, and clinicians should be able to focus on caring without burdensome obstacles.

For the commercially insured and Medicare beneficiaries enrolled in Medicare Advantage, it is often the case that the plans they are enrolled in have policies that at times unnecessarily create barriers to care. Practices such as burdensome prior authorization become systemic cost drivers and inhibit timely care. Practices that require hospitals and health systems to jump through unnecessary administrative hoops to allow for patient discharge to the next care setting or to home means patients remain in the hospital when they no longer need to be there. These policies can delay access to care, contribute to healthcare worker burnout, and drive up administrative costs.

While eligibility is expansive for Medicaid (HUSKY) beneficiaries, low payment rates often create barriers to care, especially for specialty services.