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SACRAMENTO (February 6, 2024) — Every day, an estimated 4,500 Californians are left stranded in hospital beds long after they have been medically cleared for discharge, many of them victims of insurance companies’ bureaucratic red tape or failure to have enough care providers available to help patients recover after their hospital stay. This startling statistic is among the key findings of a recent survey of hospitals conducted by the California Hospital Association (CHA).
The survey, conducted in late 2023, gathered data from hospital inpatient units, emergency departments, and inpatient psychiatric hospitals. Respondents were asked to provide information on how often delays occur and the contributing factors that result in patients being forced to stay in the hospital longer than necessary, along with the impact these delays have on a patient’s ability to recover from illness or injury. About 60% of California hospitals responded to the survey.
“Californians are facing a grave and growing threat to their ability to access critical health care services because of harmful business practices of many insurers,” said CHA President & CEO Carmela Coyle. “California law requires insurance companies to provide their members with access to timely and appropriate health care services. Yet too often these companies play games, forcing patients to remain hospitalized longer than necessary.”
When insurance companies require care to be authorized before it is delivered, patients get stuck waiting in hospital beds for red tape to clear despite being medically ready to move on. According to the CHA survey, patients whose discharge from the hospital is delayed spend at least three additional days beyond what is medically appropriate. In some extreme cases, patients — especially those experiencing a behavioral health issue — have languished unnecessarily in hospitals beds for as long as a year. Many of these delays are the result of insurers not having enough clinicians, psychiatric, skilled-nursing or rehabilitation facilities, home health services, or other types of providers within their network to care for patients after they leave the hospital.
Other findings include:
- California hospitals provide an estimated 1 million days of unnecessary inpatient care and 7.5 million hours of wasted emergency department care annually due to discharge delays.
- These delays result in at least $3.25 billion in avoidable hospital costs every year.
- Patients enrolled in managed care plans — especially those covered by Medi-Cal — are more likely to experience delays than those who have fee-for-service insurance coverage.
In addition to having inadequate provider networks, excessive prior authorization requirements are another common tactic insurers use to delay or deny care. Four out of five hospitals identified authorization delays or denials as one of the top barriers to patients getting the care they need in a timely manner.
The survey also shows that many insurers require hospitals and doctors to provide reams of paperwork before approving claims, with the hope that providers will ultimately give up on trying to be paid for care that has already been provided.
“It’s time for insurers to live up to their responsibility of ensuring access to timely and affordable care,” Coyle said. “It’s also time for state regulators to hold insurers accountable by enforcing the law. Care that is delayed is care that is denied.”