Michael Waterbury Op-Ed in The Hartford Courant: A centralized system for hospital financial assistance is necessary to drive down medical debt

Michael Waterbury Op-Ed in The Hartford Courant: A centralized system for hospital financial assistance is necessary to drive down medical debt

This article by Goodroot CEO Mike Waterbury ran in the April 8, 2023 edition of The Hartford Courant. 

Medical debt is not just a financial issue. While it’s the leading cause of bankruptcy in the United States, it’s also a public health crisis that drastically affects families throughout the country and right here in Connecticut. What do we do in times of crisis? We respond, and we take action. 

One of the tools at our disposal is hospital financial assistance. Its only weakness — and it’s a big one — is a general lack of awareness by the public. This is where Connecticut has the opportunity to step up and lead the nation by example. 

The Affordable Care Act requires all nonprofit hospitals to offer hospital financial assistance to patients. A recent survey commissioned by Goodroot revealed that 53% of households are unaware of hospital financial assistance and the vital support it can provide. And if they were aware of it, many were deterred from using it due to the unnecessary complexity of the application or the stigma of its unfortunate labeling of “charity care.” 

I fully support any measures aimed at increasing awareness, utilization and access to hospital financial assistance, and acknowledge Raised Bill No. 5320 is a step in the right direction. However, it is not comprehensive enough and falls short in its execution. 

A centralized hospital financial assistance technology portal needs to be established and live permanently on the CT.gov website. This is the key cog in the machine. We must create a single point of access where state residents can both check their financial assistance eligibility and apply for that assistance at all Connecticut-based hospitals. And it must be simple enough for everyone to use. 

The impact would be felt almost immediately. According to data from the Lown Institute’s Fair Share Spending Report, Connecticut ranks 46th among all states when it comes to what hospitals spend on financial assistance as a share of total expenses. For those who prefer the 5-star rating system, the average financial assistance rating for Connecticut hospitals is currently sitting at 1.19 out of 5. 

Many people would be shocked at the number of patients in this state who qualify. In Connecticut, a family of four earning up to $120,000, and even $170,000 at some hospitals, may be eligible for hospital financial assistance. That covers a lot of people in this state! This is why we need to act. 

There is very little accountability right now for hospitals to be proactive in offering financial assistance to patients. And since half the patients aren’t even aware the programs exist, we have to change the approach. A centralized portal is the answer. 

Another finding in the Goodroot survey is that 40% of Americans have experienced medical debt, with nearly half owing more than $2,500. An alarming 38% said they’ve had to sacrifice essentials like rent, groceries, or utilities due to medical bills. And this is not just an affliction of the uninsured — the underinsured are also not spared from the often-crippling burden of medical debt. 

What makes it a health crisis is what happens when you take things a step further. The fear of falling into medical debt — and the experience of living with it — makes people hesitant to see doctors when they really should. Something minor that could be treated easily can become something major, and both the patient’s suffering and the cost of treatment will greatly increase. 

The anticipation of potential medical debt is even more widespread than debt itself. A staggering 86% of respondents said they delayed necessary care due to anticipated costs. And even among employees with commercial insurance through their employer, 92% admitted to skipping medical care to avoid unaffordable bills. 

Several states — including Washington, Oregon, Maryland and Ohio — have successfully implemented a uniform hospital financial assistance application process for patients. Connecticut should follow suit and, in designing our portal, prioritize accessibility and simplicity. 

It’s unreasonable to ask patients who are in the throes of illness or anticipating a major medical procedure to navigate hospital websites, locate, read and understand financial assistance policy documents on their own and then try to determine if they are eligible and submit an application. 

Simplifying and streamlining the process will ensure that patients in need receive quality care and support without the added burden of bureaucratic hurdles. 

The stakes are high. The average hospital stay costs $13,000, which is an earth-shattering figure for anyone living even remotely close to paycheck to paycheck. With deductibles ranging from $2,500 to $10,000 or more, the financial strain on Connecticut residents is immense. 

Fixing something as gargantuan and broken as the American healthcare system is a titanic task. There are questions that have no answers and problems that have no solutions. 

But hospital financial assistance already exists. We just need to help patients use it. 

Raised Bill No. 5320 should be passed with the modification of a centralized hospital financial assistance technology portal — a system that will truly serve the needs of our citizens and pave the way for a brighter, healthier future for all residents of Connecticut. 

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    Experts In This Article
    Michael Waterbury
    Michael Waterbury
    Chief Executive Officer, Goodroot

    Nick McLaughlin
    CEO, Breeze

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