CHA News

CHA Analysis Reveals How Insurer Practices Impede Patient Care

What’s happening: CHA developed a detailed analysis of how insurance company practices negatively affect patients, which is a key proof point supporting a comprehensive strategy to hold insurers accountable for patient care in California. 
What else to know: One of CHA’s priorities this year is to create greater accountability (network adequacy, prior authorization, medical necessity, payment practices, and parity) for insurers operating in California.  

The survey, conducted by CHA in 2023, saw significant response from California hospitals (many thanks to all who contributed). Broadly, the analysis reveals: 

  • Four out of five California hospitals identify delays or denials of authorization as one of the top insurance policies that delay discharges. 
  • An estimated 4,500 patients every day remain in California hospitals and emergency rooms despite being medically cleared for discharge. This affects those in managed care plans at higher rates than those in fee-for-service plans. 
  • Annually, hospitals provide an estimated 1 million days of excess inpatient care due to discharge delays and 7.5 million hours of excess emergency department care. This directly contributes to at least $3.25 billion in avoidable boarding costs. 

CHA’s strategy to create greater accountability for insurers operating in California also includes:  

  • Pressing for state regulator enforcement of insurers’ harmful practices 
  • Building data needed to advocate near- and long-term 
  • Using litigation to reset the tone 
  • Educating policymakers — telling the hospital and patient story 

For questions about this analysis or our ongoing work to create greater insurer accountability, contact Patricia Blaisdell, vice president, policy, at