One of CT’s few remaining independent hospitals axes jobs but posts first surplus in years

Hartford Courant – Tuesday, April 15, 2025
By Don Stacom

The Connecticut hospital is cutting 60 administrative and clerical jobs — about a third of them through layoffs — but has been able to finish the first five months of the new fiscal year with a modest surplus instead of continuing a two-year pattern of losses that topped $30 million.

Soaring payroll costs, the state’s underinvestment in Medicaid and unreasonable taxes on hospitals are combining to attack the finances of independent hospitals around Connecticut, according to the Bristol Hospital administration.

In a January report, the Connecticut Office of Health Strategy said that the state’s 27 hospitals had a $3 billion increase in revenues from day-to-day operations between fiscal 2020 and fiscal 2023. But at the same time, expenses increased by $3.2 million.

“The majority of increased expense is attributable to three categories: Salaries and wages (29% increase), supplies and drugs (33% increase) and other operating expenses (33% increase),” the report said.

One of the biggest culprits in the worsening trend by Medicare Advantage insurers to delay or deny pre-authorizations, and later either underpay for clients’ legitimate medical expenses or refuse to pay altogether, according to hospital president Kurt Barwis.

“The amount denials and the amount of underpayments from these plans is extreme,” Barwis told the Courant on Monday. “You’re supposed to get paid Medicare (rates), but what you end up getting is 11 to 12% less.”

Bristol Hospital has about 750 employees, and Bristol Health Group, which also includes an EMS service, Ingraham Manor and a network of private physicians, employs another 700 to 800.

Barwis estimated that as many as 50 workers are assigned to working with insurance providers to secure pre-authorizations, work out billing disputes and appeal rejections or underpayments. He said each physician in the group probably spends two to four hours a week in phone consultations with insurers’ medical staff to negotiate services and authorizations.

The American Medical Association and U.S. Congress have each expressed concerns about Medicare Advantage denials. The AMA said research in 2022 is clear, though, that the track records of individual insurers vary widely.

“The vast majority of requests that were appealed in 2022 were subsequently overturned: 83.2%. This number has remained steady over the past few years,” the AMA said in a report last fall. “Medicare Advantage insurers varied in how often they denied prior authorization requests, with CVS denying the most (13%) and Anthem denying the fewest (4.2%).”

“Between 2019 and 2022, UnitedHealthcare, Humana and CVS each denied prior authorization requests for post-acute care at far higher rates than they did for other types of care, resulting in diminished access to post-acute care for Medicare Advantage beneficiaries,” said a U.S. Senate Permanent Subcommittee on Investigations report in October.

The insurance industry has disputed some of those findings saying they’re based on outdated data.

Barwis has been publicly speaking of insufficient and delayed payments by Medicare Advantage insurers for years. He has also condemned some insurers for putting out confusing or misleading marketing materials to lure senior citizens into signing up for their plans without realizing how many services, procedures and medical providers aren’t covered — or how long patients and their physicians may end up waiting for pre-authorizations.

The Centers for Medicare and Medicaid Services typically doesn’t get involved in hospital-insurer disputes, he said.

“When Congress created these plans it pretty much said (billing) issues between the plans and hospitals or doctors are outside CMS’s purview. They created a virtual Wild West, it’s a lawless environment,” he said.

Bristol Hospital has experienced several consecutive years of operating losses, but Barwis said it is positioned for improvement now. In the first five months of the new fiscal year, it has posted a $637,017 gain. The hospital said the annual savings from eliminating 60 jobs, many of which were vacant already, will save about $3.5 million over the course of a full year. Reduction in payroll expenses also includes cuts in overtime and a voluntary wage rollback for administrators.

Barwis emphasized that the job cuts don’t affect patient services. He said the hospital remains committed to also serving Southington, Plainville, Burlington, Farmington and Plymouth, where it has added physicians offices, clinics and other facilities in recent years.

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