Finance and Reimbursement
Connecticut hospitals serve as the healthcare safety net for their communities, caring for all regardless of ability to pay. Yet, because of continued deterioration in the financial health of these hospitals, their ability to ensure continued access to necessary healthcare services is threatened. Many factors impact hospitals' financial viability.
- In 2011, Connecticut hospitals provided $1 billion in unreimbursed care* and uncompensated care to patients, including those covered by state and federal programs (Medicaid, Medicaid Low Income Adults-formerly SAGA-and Medicare), which do not pay for the full cost of care. *(The shortfall resulting from Medicare and Medicaid paying hospitals less than the cost of care for beneficiaries of public programs.
- Financial losses to hospitals from inadequate Medicaid reimbursement are growing rapidly: from $360 million in FY09 to $403 million in FY10, to $478.7 million in 2011 and losses under the current payment structure are expected to double by FY14 to $750 million.
- Rising costs acquiring advanced technology, some of it related to healthcare reform, affect all hospitals. Connecticut hospitals are investing millions of dollars in health information technology to modernize patient records, make the system more efficient and improve patient care.
- The lack of capital funds to update and improve facilities is a growing concern.
- Providing charity care for an increasing number of individuals who lack insurance or the ability to pay for their care also affects hospitals financially. In 2011, hospitals in Connecticut spent $213.1 million on uncompensated care, $96.0 million in charity care and another $117.1 million that hospitals had to "write off" for patients who couldn't pay.
Connecticut hospitals remain in fragile financial health. The fundamental problem remains that the constant gap between current cost and payment is impairing the ability of Connecticut hospitals to meet today's obligations and prepare for tomorrow.
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