NEW YORK With the creation of a new Alliance for Access to Care initiative, the Catholic Health Association and the American Hospital Association aim to raise awareness of the barriers to care that patients face due to some tactics used by healthcare companies. commercial health insurance.
We are discovering more and more barriers to care that need to be made public, so we can make it clear to our policymakers that change needs to take place, said Sister Mary Haddad, president and CEO of ACS. Node.
This is a broken system, and until we are able to address the multiple problems that have contributed to this unjust health care system in the United States, we will never be able to fix it, she said. declared.
Haddad said the biggest barrier to care patients face is insurance denial. Essentially, this happens when a doctor makes a recommendation for a particular treatment, but the insurance company does not pay for it.
It is often assumed that a patient cannot get it because the hospital does not provide the care, when in reality it is the insurance company that does not pay for it, and often dictates what ‘a patient will be able to do because he does not have the means to do it, and does not do it. I want to take that risk, Haddad said.
Through the Alliance for Care initiative, this is the type of action that both organizations want to raise awareness about, as a first step toward possible congressional action. The initiative was launched through a new website, www.healthcarehere.org, whose homepage header reads: Your Pain, Their Gain: How Health Insurers Profit From Denials of Care.
The website, divided into six sections, contains statistics on the practices employed by insurance companies. The website says that, of 1,000 doctors surveyed who are part of the American Medical Association, 94 percent said that insurance companies’ prior authorization for pre-approval before treatment delayed patients’ access to necessary care, 80 percent said that prior authorization then led patients to abandon doctor-recommended care, and 25 percent said that withholding prior authorization ultimately led to the patient’s hospitalization.
The website also notes that commercial insurers have increased their premiums by 14.5 percent over the past five years. It highlights the practice of using an algorithm to approve or deny a claim, citing for example that Cigna spent an average of 1.2 seconds per case denying more than 300,000 claims.
And in another section, the website highlights increased profits in 2022 for several large commercial insurance companies: UnitedHealth Groups profits increased by 28 percent, Cignas by 70 percent, Elevance Healths by 7 percent, Centenes by 26 percent and Molinas by 60 percent, according to the website.
None of the vendors listed above immediately returned a Node request for comment.
Haddad said creating the initiative, which in addition to the website will include a paid and social media advertising campaign, was the culmination of a series of things, including hearing from more in addition to association members speaking about the issues patients face and barriers to care. .
We have been watching for some time the incredible work that my predecessor, Sister Carol Keehan, did on access to care with the Affordable Care Act, and we recognize that the end goal was not simply to get the passage of the ACA, but that there would still be many obstacles to overcome and uncover that have a real impact on people in need, Haddad said.
That’s really what pushed us to say that we’re at a moment where we really need to elevate what’s going on to tell the truth about the challenges that many people face in trying to access affordable healthcare , Haddad said.
The Catholic Health Association represents more than 600 Catholic hospitals and 1,600 long-term care and other Catholic health care facilities in the United States. Meanwhile, the American Hospital Association brings together approximately 5,000 hospitals, health care systems, networks and providers.
Haddad said the organizations have worked together in the past and because this issue affects not just Catholic but nonprofit health care providers in general, it made sense to launch the initiative together. She said it was time to start telling the truth on this issue.
The first step is simply to educate the public, Haddad said. This is what’s wrong, and for too long it’s gone unnoticed, and that’s why it’s time we start telling the truth about it so we can impact the change that needs to happen. produce, because this way of providing care is not sustainable. Today.
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