State slips in 2025 scorecard, citing ER overuse and cost barriers

CT Examiner – Wednesday, June 18, 2025
By Brian Scott-Smith

Overuse of hospital and emergency rooms, along with wide income disparities, are among the key takeaways in the Commonwealth Fund’s 2025 scorecard on Connecticut’s health system performance.

The annual report is based on continuous tracking on how each state’s health care system is working. This year, Connecticut ranks 11th place in the nation, down from sixth place in 2023 and third best in 2022.

Office of Health Strategy Commissioner Dr. Deidre Gifford said people can feel comfortable that the state’s health system in general is a high-performing one, but there are areas of concern.

“How often do people go to the emergency room when they might have avoided an emergency room visit? How often did they get admitted to the hospital for a condition that might’ve been better cared for in an outpatient setting? How often did they get readmitted back to the hospital within 30 days after a hospital visit? All of those things, Connecticut really performed in the bottom half of the country,” she said, referring to a section of the scorecard titled “Avoidable Hospital Use & Cost.”

She said part of the issue lies with the lack of doctors in the state.

“We need to work on strengthening our primary care system in Connecticut,” she said, adding that her office has been working on such initiatives. “… We’ve set a goal to reach 10% of health care spending on primary care, but talk to pretty much anybody in Connecticut, they will tell you that they’re struggling to get appointments with their primary care doctor. Our system is very fragile, and these measures really reflect that people are having trouble accessing the outpatient services that they need.”

According to the Robert Graham Center, a Washington-based organization that offers insights on primary care physicians and issues facing primary care, Connecticut will need over 400 additional primary care physicians by 2030 to maintain current levels of patient care.

Part of the state’s problem is an aging primary care workforce and poor physician retention, with only 41.7% of physicians who complete their residency in Connecticut choosing to stay and practice.

Gifford said the situation would only worsen if President Donald Trump’s Big Beautiful Bill passes.

Under the plan, Medicare payments could be slashed dramatically, affecting the level of service for recipients and health care providers across the country.

When it came to Medicaid reimbursement, Gifford pushed back.

“The Department of Social Services recently did a study looking at how we compare to our peer states. And actually, that study showed that we are pretty much in line with other states in how we pay Medicaid,” she said.

However, she acknowledged that the state needs to increase its physician rates for Medicaid reimbursement.

Connecticut also scored poorly on income disparity, which Gifford said relates to health care costs and access rather than people not having insurance.

“We know from the data that the population’s most impacted by those affordability and access challenges are low-income, racial and ethnic minority populations. They struggle the most to get the care that they need when they need it. We know that people are cutting pills in half. We know that people are avoiding getting doctor visits because of concerns about cost,” she said.

Gifford suggested the solution lies in health care costs.

“We have to bring down the cost of health care. It’s the price of health care that’s making it difficult for people to access the services that they need because they can’t afford the out-of-pocket costs,” she said.

She said there must also be more transparency in the system overall, as people can be charged substantially different prices for the same service or treatment in the state by different providers.

“You might see two or three times the charge for the same service at one health system as against another. Well, why is that? It’s often not explained by any relationship to quality or health outcomes or the underlying cost of the service. The fact is that these prices are negotiated between insurance companies and providers, and they often are negotiated at a very different level for one provider than they are at another,” she said.

Gifford’s office plans to discuss the scorecard and the state of health care in Connecticut at its Healthcare Benchmarks Initiative Informational Hearing on June 23.

In response to the latest scorecard, the Connecticut Hospital Association emphasized that the state remains a national leader in health system performance.

“The Commonwealth Fund’s Report identifies Connecticut’s health system as a top performer nationally — a testament to the hard work and dedication of healthcare professionals across the state. We are dedicated to continual improvement and ensuring equity in care delivery and that patients have access to the right care, at the right place, at the right time remains imperative,” the association said in a statement.

Access this article at its original source.