What’s happening: On March 20, CHA convened a small group of hospital leaders for an in-depth discussion in southern California — led by CHA President & CEO Carmela Coyle — with state Health Secretary Mark Ghaly, MD, MPH. In the meeting, they had the opportunity to share perspectives on how harmful insurance practices are impeding patient care and threatening hospitals’ ability to provide care. This is part of CHA’s focus on holding insurance companies operating in California accountable for protecting patients and the providers who care for them.
What else to know: Hospital leaders attending the meeting were: Laureen Driscoll, division chief executive, Providence South Division, Providence; Lori Morgan, MD, MBA, President & CEO, Huntington Health, Roger Sharma, President & CEO, Emanate; Julie Sprengel, California division president, CommonSpirit Health; and Doug Sturnick, senior vice president, Managed Care and Payer Relations, Cedars-Sinai. Joining by phone were the Health and Human Services assistant secretary and heads of the Department of Health Care Services and Department of Managed Health Care.
During the conversation, hospital leaders provided their perspective on how the lack of insurer compliance with requirements was affecting patient access to care. Several themes emerged:
- Payer behavior is worse now than in the past.
- Major issues include excessive and unnecessary use of prior authorization, delays, denials, lack of qualified personnel to evaluate, and inconsistent standards.
- Financial distress is so significant that without better support from insurance companies, more hospitals will close or reduce services.
- California already has strong laws that address many of these issues, but compliance and enforcement need improvement.
Up next: CHA is organizing a second meeting between Sec. Ghaly and hospital leaders in Northern California to continue the discussion.
