ϳԹ

© 2024 ϳԹ

FCC Public Inspection Files:
· · ·
· · · · ·
Public Files Contact · ATSC 3.0 FAQ
Play Live Radio
Next Up:
0:00
0:00
0:00 0:00
Available On Air Stations

Repeated claim denials threatening the future of Bristol Health, CEO says

Rep. Rosa DeLauro (D-CT) speaks during a news conference on Medicare Advantage plans in front of the U.S. Capitol on July 25, 2023 in Washington, DC. Joined by Medicare advocates, Congressional Democrats held a news conference “to call for action to stop wrongful delays and denials in private Medicare Advantage plans, to end to fraudulent overpayments, and to mandate accountability for the worst actors who hurt patients.”
Alex Wong
/
Getty Images North America
Rep. Rosa DeLauro (D-CT) speaks during a news conference on Medicare Advantage plans in front of the U.S. Capitol on July 25, 2023 in Washington, DC. Joined by Medicare advocates, Congressional Democrats held a news conference “to call for action to stop wrongful delays and denials in private Medicare Advantage plans, to end to fraudulent overpayments, and to mandate accountability for the worst actors who hurt patients.”

Cash-strapped Bristol Hospital has received $17,000 in donations from the community, and is hoping to raise a total of $1 million by the end of the year.

It’s two days worth of cash on hand — a drop in the bucket compared to the money the health care system says it’s losing in insurance claims denied by private Medicare Advantage plans.

“I had a patient in my ICU on Medicare Advantage [who] really should have been placed into a long-term, post-acute ventilator facility,” said Kurt Barwis, CEO of Bristol Health. “After hundreds of days of care, and probably close to $2 million in charges, yet today, I have not been paid one dime, one dime. Medicare Advantage paid nothing.”

Nationwide, hospital CEOs say Medicare Advantage . For Bristol Health, the financial stress was worsened by cash reserves depleted by the COVID-19 pandemic.

The health system includes a hospital and over 100 provider networks in ϳԹ. Private Medicare Advantage plans cover more than a quarter of its patients, but Barwis says Medicare Advantage denies so many claims it’s threatening the hospital’s future.

“How do you exist when Medicare Advantage just consistently denies 18% of what you bill them on a claims basis?” Barwis said.

More than a dozen hospitals across the country have stopped accepting Medicare Advantage patients, according to Becker’s Hospital Review.

As Bristol Health continues to face financial challenges, Barwis says he’s optimistic people will keep donating money to help.

“The community itself created the hospital 102 years ago because of the Spanish flu pandemic,” Barwis said. “So the community came together to say, 'we need a place to take care of our community, we need to invest in this organization.'"

Sujata Srinivasan is ϳԹ Radio’s senior health reporter. Prior to that, she was a senior producer for Where We Live, a newsroom editor, and from 2010-2014, a business reporter for the station.

Stand up for civility

This news story is funded in large part by ϳԹ’s Members — listeners, viewers, and readers like you who value fact-based journalism and trustworthy information.

We hope their support inspires you to donate so that we can continue telling stories that inform, educate, and inspire you and your neighbors. As a community-supported public media service, ϳԹ has relied on donor support for more than 50 years.

Your donation today will allow us to continue this work on your behalf. Give today at any amount and join the 50,000 members who are building a better—and more civil—ϳԹ to live, work, and play.

Related Content
ϳԹ’s journalism is made possible, in part by funding from Jeffrey Hoffman and Robert Jaeger.