KHN’s chief Washington correspondent, Julie Rovner, who has lined well being look after greater than 30 years, affords perception and evaluation of insurance policies and politics in her common HealthBent columns.
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Congress is on the verge of approving a large funding invoice that may steer an unprecedented amount of money to the nation’s hospitals which can be or quickly can be struggling to deal with the COVID-19 pandemic.
While the bottom-line quantity for that assist is near $200 billion, it stays to be seen how briskly the federal Treasury will transfer the cash and whether or not it’ll get to the place it’s most wanted.
“It provides what we asked for,” stated Chip Kahn, president and CEO of the Federation of American Hospitals, which represents for-profit amenities. “Are all the resources here the right ones? We’ll find out.”
The Senate, after practically per week of negotiations amongst Republicans, Democrats and the White House handed the invoice Wednesday night time. It is scheduled for a vote within the House on Friday.
About $100 billion of the funding is meant to, because the invoice places it, “reimburse … eligible health care providers for health care related expenses or lost revenues that are attributable to coronavirus.”
Hospitals are experiencing one thing distinctive on this pandemic. Not solely are they being pressured in lots of circumstances to show away their regular sources of income, like joint replacements and different elective procedures, however they’re additionally experiencing a surge in very sick COVID-19 sufferers more likely to eat massive quantities of hospital assets for a very long time.
That $100 billion can be administered by the U.S. Department of Health and Human Services’ assistant secretary for preparedness and response. The place was created by a 2006 law handed within the wake of Hurricane Katrina supposed to centralize authority over public well being emergencies. Among different issues, the workplace oversees the Strategic National Stockpile, which shops medicine and different medical gear for use in emergencies.
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But already folks spot potential bother spots on this invoice. That so-called preparedness workplace “does not have the capacity to run such a massive provider payment program,” wrote Kim Monk, a well being coverage advisor with Capital Alpha Partners, in a observe to purchasers and reporters. “It will be a major challenge to distribute the funds in an equitable manner and also fast enough to help hospitals and other providers financially devastated by the pandemic, primarily due to the deferral of lucrative elective procedures.”
Christopher Holt of the conservative American Action Forum wrote in his abstract of the invoice: “Unfortunately, there isn’t much detail in the legislative text regarding this $100 billion or how it will be disbursed.”
That ambiguity hasn’t stopped hospitals from already jockeying to verify they get their share.
“The money needs to not run out before you get to the big places,” stated Dr. Atul Grover of the Association of American Medical Colleges, which represents instructing hospitals. While the federal funds is perhaps the distinction between staying open and having to shut for some smaller, rural amenities, he stated, the massive, city hospitals have a “larger magnitude of losses and concentration of patients.”
But whereas city hospitals are caring for the majority of sufferers, the necessity for monetary assist in rural areas is much more dire, stated Maggie Elehwany of the National Rural Health Association. “A whole lot of these amenities have been already vulnerable,” she stated, including that half of all rural hospitals “are already operating at a loss.”
Elehwany stated that whereas rural hospitals are grateful for the assistance coming their method, the group is sad that a certain quantity was not put aside for rural well being care. “They just don’t have the cash on hand to deal with this,” she stated, significantly after having to shut down outpatient and elective companies.
The laws is surprisingly obscure on precisely how the cash can be distributed, though most of those that have been working to form it assume that HHS Secretary Alex Azar will seemingly have a serious position to play. Typically a pot of cash that enormous would include strict system necessities.
The invoice consists of a number of different provisions geared toward serving to hospitals.
For instance, below the laws, hospitals could be given an instantaneous 20% bonus for prices related to treating sufferers with COVID-19, the sickness attributable to the coronavirus. The federal authorities can also be canceling a 2% across-the-board minimize in Medicare reimbursements that was arrange in an earlier price range invoice and laying aside some cost reductions deliberate for hospitals that deal with massive numbers of low-income and uninsured sufferers.
It additionally consists of cash to assist hospitals purchase protecting gear for docs, nurses and different personnel working with coronavirus sufferers.
And most hospitals would have the ability to accumulate a no-interest-for-a-year mortgage equal to a earlier six months of Medicare funding they acquired. Hospitals in rural and different underserved areas could be eligible for 125% of that quantity upfront.
But even that might be problematic, in accordance with the National Rural Health Association’s Elehwany. “How are hospitals that are already operating at a loss going to be able to pay that back?” she stated. Some of the amenities she’s been in touch with “only have cash on hand for the next couple of days” and are having problem acquiring wanted provides and preserving workers.
Kahn of the for-profit hospital group, who has been concerned in practically each main piece of well being laws for the previous three a long time, famous that “this is an unprecedented program by anybody’s definition. There’s never been a fund this large that was designed to be handed out in grants, particularly a fund with the expectation of all involved that it will be distributed very rapidly. But the crisis is upon us.”
HealthBent, a daily function of Kaiser Health News, affords perception and evaluation of insurance policies and politics from KHN’s chief Washington correspondent, Julie Rovner, who has lined well being look after greater than 30 years.
Use Our Content This story might be republished totally free (details).
Julie Rovner: [email protected]”>[email protected], @jrovner
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