Without the legislature’s help, more NC hospitals will close

The writer is chair of the Harnett County Board of Commissioners.

During the height of the pandemic, we saw a significant increase in public support for our nation’s healthcare providers – and rightfully so. Doctors and nurses across the country, including those right here at Betsy Johnson and Central Harnett hospitals in Harnett County, went above and beyond to care for patients, and we rallied behind them.

We delivered meals to them, shopped and ran errands for them, and cheered them on to let them know we appreciate the care and service they provide to us and our loved ones.

Unfortunately, while the critical work of our hospitals and medical centers remains as important as ever, support for providers, workers, and patients appears to be waning – especially from our state’s insurers.

North Carolina hospitals, especially those in rural areas, have yet to bounce back from the pandemic – with a large percentage continuing to experience negative operating incomes. While our already struggling hospitals are currently absorbing the cost of inflation instead of passing costs along to patients, as is common practice in almost every industry, we see insurance companies simultaneously increasing member premiums and taking steps to drastically reduce the amount they are required to reimburse health providers for the care they deliver to patients.

If hospitals are forced to accept unsustainable reimbursement rates from insurers that fail to account for the income shortfalls and increased costs they face, it will only exacerbate their current financial troubles and put the communities served by these providers at greater risk.

North Carolina has already seen eight rural hospitals close over the last decade. We cannot afford to lose any more.

As if the risk of fewer hospitals and rising insurance premiums isn’t enough for patients to worry about, there has been an uptick in claim denials by insurers in recent years.

North Carolina’s average denial rate is now above the national average at approximately 15% of all claims, and these denials often run counter to what doctors and nurses recommend for their patients. Only about 0.1% of patients whose claims are denied appeal the decision to an external review organization. Of those patients who do, 32% are successful in getting their claim covered.

With that kind of low engagement, insurers seem to be banking on the arduous and confusing appeals process to save themselves millions each year.

These are precious dollars that patients end up having to pay out of their own pockets – in addition to the premiums that insurers already take from these patients each month. That means fewer dollars North Carolinians have to spend on household necessities or otherwise put back into our local economy.

Our healthcare providers, workers and patients deserve better. The health and well-being of our families and communities is at stake. It’s on us to take the steps needed to ensure North Carolina’s healthcare facilities remain well staffed, accessible and on a strong financial footing. I encourage our elected officials in the General Assembly to take up these issues, especially the recent actions we’ve seen from our state’s health insurers which have increased costs for providers and patients.

This story was originally published October 10, 2022 at 4:30 AM with the headline "Without the legislature’s help, more NC hospitals will close."