In 2025, the average wait time to be treated in Hartford Hospital’s emergency department was nearly nine hours.
That’s according to an online database maintained by the Connecticut College of Emergency Physicians (CCEP), which tracks so-called “boarding” statistics for the state’s 26 acute-care hospitals.
The 8.9-hour average wait was the worst of any state ED last year. Charlotte Hungerford Hospital in Torrington and William Backus in Norwich — each also owned by Hartford HealthCare (HHC) — tied for the second-worst, with average wait times at 8.4 hours.
The state’s busiest emergency department at Yale New Haven Hospital had an average wait time of 5.4 hours. That was despite treating 228,586 patients last year vs. the 109,166 treated at Hartford Hospital, according to CCEP.
As overcrowding pressures mount, Hartford HealthCare is making expansion and modernization of the ED a major focus of a more than $1 billion plan to remake 15 buildings on and around its Hartford campus.
The plan, details of which were recently unveiled, also includes renovating the former Girl Scouts headquarters at 340 Washington St. into a GoHealth Urgent Care center. Hartford HealthCare acquired the building last year.
The project’s centerpiece is a new $950 million, 14-story inpatient tower featuring 216 additional private patient beds and three floors of procedural space for electrophysiology, cardiac catheterization, gastroenterology and ambulatory surgery.
The initiative also includes a new patient arrival center with a two-story atrium, a 1,650-car parking garage and 500-seat conference center.
Hartford HealthCare plans to finance the overhaul in part through approximately $850 million in bond financing, along with endowment funds and private fundraising.
But Jeffrey Flaks, president and CEO of Hartford HealthCare, said the investment is ultimately about more than construction. He described it as a once-in-a-generation effort to modernize the hospital and improve the areas of care that matter most to patients.
Industry observers say the initiative also reflects a broader strategic shift across healthcare, as major systems nationally invest heavily in access, patient flow and campus modernization to strengthen their competitive positions in the post-pandemic marketplace.
“What Hartford HealthCare is endeavoring to do is what many of the largest health systems around the country are doing now, which is to provide easy access to definitive care,” said Jeff Hogan, president of Upside Health Advisors, a Farmington-based industry consultancy.
“The big health systems are building out their infrastructure, for better or worse, so that they will get more brand loyalty,” Hogan added.
‘Completely overwhelmed’
There is little debate that many hospital emergency departments — particularly Level I trauma centers like Hartford Hospital’s — are under intense strain.
“EDs are completely overwhelmed,” Hogan said.
According to Karen Goyette, executive vice president and chief strategy and transformation officer for HHC, Hartford Hospital’s emergency department sees about 300 patients daily.
“It’s probably one of the busiest in the United States,” she said.
A February report published by Becker’s Hospital Review ranked Hartford Hospital’s ED as the 44th busiest in the nation last year. Yale New Haven Hospital ranked third.
Hartford Hospital also refers pediatric emergency cases to nearby Connecticut Children’s Medical Center, which treated roughly 58,000 patients last year, according to the CCEP database. Combined, the two facilities would rank among the busiest emergency care hubs in the country.
Goyette said overcrowding is driven in part by patients using emergency rooms because they lack access to primary care and other healthcare resources.
“Unfortunately, the reality is that many people today lack primary care, lack resources, and they’re … utilizing our emergency department as their first line of defense,” she said.
The planned 2,500-square-foot urgent care center on Washington Street is intended to divert lower-acuity cases away from the ED and free emergency staff to focus on patients requiring more intensive treatment, she said.
Hartford HealthCare operates 50 urgent care centers statewide, which Goyette said each handle “upwards of 75 patients a day.”
Hartford HealthCare is also reserving about 1,500 square feet in the former Girl Scouts building for four additional patient rooms to accommodate future demand.
Expanding the ED will also include renovating the first floor of the adjacent Conklin Building into 30 observation beds for behavioral health and mental health patients who are often “warehoused” in the emergency department while awaiting placement elsewhere, Goyette said.
The new beds are expected to open within six months and should help reduce wait times, she said.
Understaffing can also contribute to emergency department overcrowding, but Flaks said Hartford HealthCare plans to hire additional clinical and administrative workers to support the expansion.
Financial strength
The project’s scale comes with significant financial commitments beyond construction costs alone.
According to Flaks, thousands of patients who currently seek care in Hartford Hospital’s emergency department each year are expected to be redirected to the urgent care facility.
An average emergency department visit can generate roughly $1,300 in revenue or more, he said, while an urgent care visit may generate closer to $120 — or, in some cases, no reimbursement at all.
That’s a significant tradeoff given that many hospitals operate on thin margins. Hartford HealthCare generated an operating margin of about 2.8% in fiscal 2025, according to audited financial statements.
“The bottom line is, this is about making healthcare more affordable,” Flaks said. “It’s about making it more accessible, and it’s about making it better.”
Flaks said Hartford HealthCare is positioned to absorb the project’s long-term debt costs because of years of financial discipline and strong operating performance.
Hartford HealthCare currently maintains an A+ bond rating with a stable outlook from Fitch Ratings, which cited the organization’s strong market position and improving operating performance.
Hartford HealthCare reported positive financial results in each of the last two fiscal years, posting operating income of $201.4 million on $7.1 billion in revenue in fiscal 2025, compared with operating income of $133.6 million on $6.5 billion in revenue a year earlier, according to audited financial statements.
“We have carefully managed our financial strength for many years, and have put ourselves in this position to make this investment,” Flaks said.
Capturing care
Hogan, the healthcare consultant, said large health systems increasingly are investing in infrastructure and patient access as they compete to keep more care within their own networks.
He cited a 2025 report from healthcare consulting firm Vizient that found the typical health system captures less than half of a patient’s total healthcare spending. According to the report, a 1% increase in loyal patients — those who repeatedly return to the same hospital or health system for care — can generate “a $40 million revenue lift for a $2 billion health system.”
Hogan said many of the nation’s largest health systems are investing in modern facilities, expanded outpatient access and private patient rooms in an effort to attract and retain aging baby boomers and commercially insured patients.
He said Hartford HealthCare has also spent decades improving both quality metrics and patient experience, helping position it competitively against rival systems.
“Basically, all of their hospitals now are ‘A’ quality” as measured by Leapfrog safety grades, Hogan said. “They focused on that.”
Flaks said the Hartford campus overhaul is especially significant because Hartford HealthCare has not undertaken a project of this scale since construction of the original high-rise hospital tower on Seymour Street in 1947.
State Sen. Saud Anwar (D-South Windsor), co-chair of the state legislature’s Public Health Committee and a physician, said he welcomes Hartford HealthCare’s investment, particularly plans to expand and improve the emergency department.
“The number and kinds of people in our waiting rooms are increasing,” he said. “We have to have our physical infrastructure and intellectual infrastructure ready to take care of people’s needs.”
But Anwar said whether the project will lower healthcare costs is “a different question,” noting that hospitals face broader financial pressures, including Medicare and Medicaid reimbursement rates that often fail to cover the full cost of care.
“You want to provide the best care at the best time at the best place,” he said. “That’s the principle.”
