Payer CareSource Presents Financing Assist to Rural Georgia Hospitals

CareSource, a Georgia-based managed care plan, just lately created a Rural Entry Development Program (RAAP) to help rural hospitals and hospital-owned expert nursing house services in rural Georgia tackle money deficits which may in any other case result in service limitations or hospital closures. 

Taylor Well being Care Group in Cochran, Ga., used $750,000 in emergency funding from this system for important vendor funds to keep up the operational integrity of Taylor Regional Hospital. In a current interview with Healthcare Innovation, Jon Inexperienced, CEO of two-hospital Taylor Healthcare Group, and Jason Bearden, president of CareSource Georgia, spoke in regards to the dire state of rural healthcare within the Southeast and the targets of the brand new program. 

Healthcare Innovation: Earlier than we speak in regards to the Rural Entry Development Program, Jason, might you describe CareSource? 

Bearden: CareSource is the one nonprofit Medicaid managed care plan in Georgia, which I believe is a defining attribute. We cowl 440,000 people throughout the state, in all 159 counties. That is 400,000 Medicaid and simply shy of 40,000 Market members. 

HCI: We all know that rural hospitals throughout the U.S. are struggling. Might you speak in regards to the scenario within the Southeast and Georgia specifically?

Bearden: We rank third within the nation for hospital closures. Rural hospitals are extremely essential to our communities. We now have a vested curiosity in seeing these rural hospitals keep open. These closures had been staved off through the COVID interval, however issues are getting just a little uneasy once more. A few of the funding sources have dried up, and we’re seeing some instability. So we’re hoping that this little bit that we are able to do by this partnership will actually facilitate stabilization of that rural hospital ecosystem, and hopefully we are going to get out of that third-highest nation hospital closure price.

HCI:  What occurs in a small, rural group when the native hospital closes?

Bearden: The obvious impression is the entry points that we see. A lot of our rural hospitals over the past 20 years have opened up OB/GYN models the place mothers might keep of their communities and have their youngster of their communities. When that hospital finally ends up shutting their doorways, we see these OB/GYN models dry up as a result of these are loss leaders. In lots of instances, we see emergent providers which might be vital for triage and stabilization dry up. These are among the most evident access-to-care points. However I believe among the extra painful outcomes of hospital closures are financial in nature. We see hospitals definitely being financial engines in rural Georgia, and when the hospital dies, it is powerful to recruit companies and jobs dry up, and the group withers. It’s a demise spiral, of types, economically due to that hospital being unable to maintain its doorways open. 

HCI: How did the thought for the Rural Entry Development Program develop? 

Bearden: This actually is a byproduct of our nonprofit standing and nature. We will do issues that our for-profit counterparts won’t have the ability to do. This was an thought born out of a partnership with Hometown Well being, a community of roughly 40 rural hospitals in Georgia, of which Jon is a member. Their govt director informed me that numerous instances they’ve money crunches at a few of their smaller hospitals, between capital campaigns or between funding sources coming from the federal authorities or the state authorities. They are going to get these funding sources from the financial institution or the feds or the state, nevertheless it’s only a time window hole.

HCI: Jon, might you speak in regards to the the scenario that Taylor discovered itself in, in order that one thing like this program would show useful? 

Inexperienced: With COVID, labor and provide prices, every little thing simply went considerably increased. You’ll be able to nonetheless do the identical degree of enterprise, and it simply prices much more to do it. In order that’s the place numerous rural hospitals are discovering themselves. I had the very lucky circumstance of attending to know Jason fairly properly. We began brainstorming on how we might determine a approach to assist, a minimum of in small interim areas, to stabilize the hospitals once they get right into a scenario the place they’re confronted with probably door-closing points. 

We needed to make it possible for we made payroll, as a result of typically our business funds are available in slower. After we offer the providers, we’re up-fronting numerous value in rural drugs. I believe we made this association in two days or one thing like that, and bought us what we would have liked, and that helped us alongside for just a few months.

I have been in healthcare for almost 30 years now, and I do not know if I’ve ever had a payer include an answer like this. This program helps not solely Taylor Regional, however might help different hospitals throughout the state. We put out a press launch about this on the state capitol, and it was well-received. I began getting calls the subsequent day or two, and began placing them in contact with CareSource to assist them in comparable conditions.

HCI: In different states, we now have seen examples of smaller group hospitals and rural hospitals getting bought or turning into associates of enormous, built-in well being programs similar to educational medical facilities. Is {that a} risk for a few of these smaller hospitals in Georgia? 

Bearden: During the last 5 years, the massive programs have acquired a few of these smaller hospitals and absorbed them — not simply the hospital, however the doctor practices.

HCI: Jon, do you see extra hospitals like yours going that route? 

Inexperienced: I actually do. I believe that except one thing completely different occurs, that is most likely the trail that almost all hospitals must take throughout the subsequent 5 years. We don’t have the negotiation energy with contracts like bigger programs do. We might nonetheless stay Taylor as a part of a much bigger system, however roll underneath their capability to barter contracts due to the sheer quantity that they supply. 

HCI: A couple of years in the past HHS launched one thing known as a Rural Emergency Hospital designation, which I believe required hospitals to surrender their acute care beds, however they’d stay open as emergency services. I perceive that not very many hospitals took them up on that. Did you take a look at that?

Inexperienced: Are you aware, we really did take a look at it. We utilized simply to see what it regarded like, after which we determined to tug again. You lose all of your inpatient beds, proper? You’ll be able to nonetheless have statement beds, however you lose ICU beds. Anybody healthcare will let you know this — it’s a must to have switch agreements with different hospitals. Even now, with the very small variety of rural emergency hospitals within the state, you virtually can not discover an ICU mattress to switch a affected person to. So you take probably the most important and most difficult-to-find mattress away. This program regarded it will begin to take income away from an already-strained system.

HCI: Jason, anything you wish to add?


Bearden: It is actually a well being fairness subject for us round entry. Whenever you take a look at rural vs. city, the entry actually breaks down while you get out into the southern and northern components of Georgia, outdoors the metro space. We do not instantly profit in any approach financially from this program, however the individuals we serve do. We care in regards to the individuals we serve, and we put individuals first. And folks we serve are definitely our members, nevertheless it’s individuals like Jon, too, as a result of Jon serves an important function in his group, not solely offering his group with high-quality providers, however being an employer of be aware. Once more, as a lot as that is about healthcare entry, it is also about employment. The hospital is an financial engine in that rural group, and that’s important to our state’s vitality long-term.