American Rescue Plan’s $8.5 billion rural fund isn’t just for rural providers

Rural healthcare suppliers cheered the Well being and Human Companies Division’s announcement earlier this month that it was sending $8.5 billion in COVID-19 stimulus funding their approach.

However giant well being programs with greater than 100 hospitals and billions of {dollars} in income are additionally eligible for the cash as standalone, rural hospitals, they usually intend to get their share.

The grants are a part of the American Rescue Plan, a sweeping, $1.9 trillion pandemic aid package deal Congress approved earlier this year. HHS mixed its September 10 information in regards to the rural ARP grants with its choice to launch one other $17 billion in extremely anticipated Supplier Aid Fund grants, the fourth distribution underneath that package deal.

Eligibility for ARP’s rural fund is predicated on whether or not the sufferers are rural, not the suppliers. Suppliers should both be positioned in or serve sufferers who dwell in rural areas and have billed Medicare, Medicaid or the Kids’s Well being Insurance coverage Program between January 1, 2019 and September 30, 2020. Rural well being clinics, vital entry hospitals and in-home well being, hospice or long-term service suppliers are additionally eligible.

The excellence between “suppliers who serve rural sufferers” and “rural suppliers” is essential as a result of it opens eligibility to giant, city suppliers that additionally deal with rural sufferers, stated Brock Slabach, chief operations officer for the Nationwide Rural Well being Affiliation, a commerce group for rural suppliers.

The NRHA would have most popular the cash be reserved particularly for rural suppliers, not rural sufferers, though it is higher than nothing, Slabach stated.

“It isn’t that we’re towards city hospitals gaining access to these funds, but it surely simply modifications the dynamic in the place that $8.5 billion could find yourself,” he stated.

CommonSpirit Well being, a 140-hospital system that introduced in north of $33 billion in income within the yr ended June 30, is among the many giant programs that plans to use for the ARP’s rural fund. Dan Morissette, CommonSpirit’s chief monetary officer, stated on an investor name final week that the Chicago-based system plans to use for a portion of the ARP rural distribution “as quickly as doable.” CommonSpirit may also apply for the fourth part of PRF grants.

Morissette stated CommonSpirit usually receives about 1% of whole distributions. The not-for-profit system additionally obtained greater than $110 million from the PRF distribution focused particularly for rural hospitals, a small portion of the entire $1.5 billion in whole PRF grants it has acknowledged underneath this system.

CommonSpirit didn’t present a remark earlier than deadline.

“Being an enormous system would not make you ineligible for this rural distribution,” stated Nathan Baugh, director of presidency affairs for the Nationwide Affiliation of Rural Well being Clinics. “It isn’t reserved for small programs which can be solely based mostly in rural areas. I am certain these programs would like this funding was only for them and never everybody who serves rural sufferers.”

HHS has stated the quantities suppliers get from the ARP might be based mostly on the quantity of Medicaid, CHIP and/or Medicare providers they supplied to sufferers who dwell in rural areas. The ARP rural funds will usually be based mostly on Medicare reimbursement charges.

“The funding might be distributed with an eye fixed in direction of fairness, to make sure suppliers who serve our most weak communities will obtain the help they want,” HHS Secretary Xavier Becerra stated in a press release when the ARP rural fund was introduced.

Rural People are dying of COVID-19 at greater than twice the speed of their city counterparts, new data from the Rural Coverage Analysis Institute present. Rural areas had been largely spared from the pandemic’s preliminary surge, however that is modified in current months with the delta variant.

Making use of for the ARP rural fund means merely checking ‘sure’ in a field on the appliance for PRF’s fourth part, Baugh stated. Because it’s such a low barrier to entry, Baugh stated he thinks nearly each supplier will decide in.

“I think loads of the massive programs, as a result of they’re making use of for part 4, will go forward and examine ‘sure’ and let the federal government work out if they’ve sufficient sufferers to let the federal government pay them a number of the funding from that rural bucket,” he stated.

The textual content of the ARP features a provision that defines a rural supplier as being positioned in a metropolitan statistical space with fewer than 500,000 residents, however the Well being Sources and Companies Administration has taken a distinct strategy to implementing the legislation, focusing the agricultural designation on the affected person, not the supplier.

It isn’t shocking that giant, multi-hospital programs would apply for the agricultural aid funds, stated Gregory Etzel, a companion within the legislation agency Morgan Lewis’ healthcare observe group.

“Congress seems to have sought to make the attain of these funds broad sufficient to embody the agricultural communities served by such hospitals whether or not or not the hospital itself is located in a rural space,” he stated.

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