CareSource, a Georgia-based managed care plan, lately created a Rural Entry Development Program (RAAP) to help rural hospitals and hospital-owned expert nursing house services in rural Georgia deal with money deficits that 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 crucial vendor funds to take care of 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 concerning the dire state of rural healthcare within the Southeast and the objectives of the brand new program.
Healthcare Innovation: Earlier than we discuss concerning 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 discuss concerning the scenario within the Southeast and Georgia specifically?
Bearden: We rank third within the nation for hospital closures. Rural hospitals are extremely vital to our communities. Now we have a vested curiosity in seeing these rural hospitals keep open. These closures had been staved off in the course of the COVID interval, however issues are getting a bit uneasy once more. A number of the funding sources have dried up, and we’re seeing some instability. So we’re hoping that this little bit that we will do by way of this partnership will actually facilitate stabilization of that rural hospital ecosystem, and hopefully we’ll get out of that third-highest nation hospital closure fee.
HCI: What occurs in a small, rural group when the native hospital closes?
Bearden: The obvious impression is the entry points that we see. Lots of our rural hospitals over the past 20 years have opened up OB/GYN items 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 items dry up as a result of these are loss leaders. In lots of circumstances, we see emergent providers which might be needed for triage and stabilization dry up. These are among the most blatant 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 loss of life 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 are able to do issues that our for-profit counterparts won’t be capable of do. This was an concept 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 government director informed me that a variety of 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, but it surely’s only a time window hole.
HCI: Jon, might you discuss concerning the the scenario that Taylor discovered itself in, in order that one thing like this program would show helpful?
Inexperienced: With COVID, labor and provide prices, every little thing simply went considerably greater. You possibly can nonetheless do the identical stage of enterprise, and it simply prices much more to do it. In order that’s the place a variety of rural hospitals are discovering themselves. I had the very lucky circumstance of attending to know Jason fairly effectively. We began brainstorming on how we might work out a method 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 doubtlessly door-closing points.
We needed to make it possible for we made payroll, as a result of typically our industrial funds are available slower. After we offer the providers, we’re up-fronting a variety of value in rural drugs. I believe we made this association in two days or one thing like that, and obtained 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 may 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 have now seen examples of smaller group hospitals and rural hospitals getting bought or turning into associates of huge, built-in well being techniques corresponding to tutorial medical facilities. Is {that a} chance for a few of these smaller hospitals in Georgia?
Bearden: Over the past 5 years, the massive techniques 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 truthfully do. I believe that except one thing totally different occurs, that is most likely the trail that almost all hospitals must take inside the subsequent 5 years. We shouldn’t have the negotiation energy with contracts like bigger techniques do. We might nonetheless stay Taylor as a part of an even bigger system, however roll underneath their means 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 might stay open as emergency services. I perceive that not very many hospitals took them up on that. Did you have a look at that?
Inexperienced: Are you aware, we truly did have a look at it. We utilized simply to see what it seemed like, after which we determined to tug again. You lose all of your inpatient beds, proper? You possibly can nonetheless have statement beds, however you lose ICU beds. Anybody healthcare will inform you this — you must have switch agreements with different hospitals. Even now, with the very small variety of rural emergency hospitals within the state, you virtually can’t discover an ICU mattress to switch a affected person to. So you take probably the most crucial and most difficult-to-find mattress away. This program seemed it could begin to take income away from an already-strained system.
HCI: Jason, anything you need to add?
Bearden: It is actually a well being fairness subject for us round entry. While you have a look at rural vs. city, the entry actually breaks down whenever you get out into the southern and northern components of Georgia, outdoors the metro space. We do not immediately profit in any method financially from this program, however the folks we serve do. We care concerning the folks we serve, and we put folks first. And folks we serve are definitely our members, but it surely’s folks like Jon, too, as a result of Jon serves a significant position 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 very important to our state’s vitality long-term.