CareSource, a Georgia-based managed care plan, not too long ago created a Rural Entry Development Program (RAAP) to help rural hospitals and hospital-owned expert nursing dwelling services in rural Georgia tackle 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 vital 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 objectives of the brand new program.
Healthcare Innovation: Earlier than we discuss in regards to the Rural Entry Development Program, Jason, may 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 in regards to the state of affairs within the Southeast and Georgia particularly?
Bearden: We rank third within the nation for hospital closures. Rural hospitals are extremely vital to our communities. We now have a vested curiosity in seeing these rural hospitals keep open. These closures have been staved off throughout the COVID interval, however issues are getting just a little 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 means of 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 neighborhood when the native hospital closes?
Bearden: The obvious influence is the entry points that we see. A lot of our rural hospitals during the last 20 years have opened up OB/GYN items the place mothers may keep of their communities and have their little one 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 instances, we see emergent companies which are crucial 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 actually being financial engines in rural Georgia, and when the hospital dies, it is robust to recruit companies and jobs dry up, and the neighborhood 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 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 govt director informed me that lots of occasions 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 will get these funding sources from the financial institution or the feds or the state, nevertheless it’s only a time window hole.
HCI: Jon, may you discuss in regards to the the state of affairs that Taylor discovered itself in, in order that one thing like this program would show priceless?
Inexperienced: With COVID, labor and provide prices, all the things simply went considerably increased. You’ll be able to nonetheless do the identical stage of enterprise, and it simply prices much more to do it. In order that’s the place lots 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 may determine a means to assist, not less than in small interim areas, to stabilize the hospitals after they get right into a state of affairs the place they’re confronted with doubtlessly door-closing points.
We needed to guarantee that we made payroll, as a result of typically our industrial funds are available in slower. After we offer the companies, we’re up-fronting lots of price in rural drugs. I believe we made this association in two days or one thing like that, and acquired 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 will 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’ve seen examples of smaller neighborhood hospitals and rural hospitals getting bought or turning into associates of huge, built-in well being methods akin to tutorial medical facilities. Is {that a} risk for a few of these smaller hospitals in Georgia?
Bearden: During the last 5 years, the massive methods 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 completely different occurs, that is in all probability the trail that the majority hospitals must take throughout the subsequent 5 years. We shouldn’t have the negotiation energy with contracts like bigger methods do. We may nonetheless stay Taylor as a part of an even bigger system, however roll underneath their potential to barter contracts due to the sheer quantity that they supply.
HCI: Just a few 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: Have you learnt, we truly did take a look at it. We utilized simply to see what it regarded like, after which we determined to drag again. You lose all of your inpatient beds, proper? You’ll be able to nonetheless have remark beds, however you lose ICU beds. Anybody healthcare will let you know this — you need 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 are taking probably the most vital and most difficult-to-find mattress away. This program regarded it could begin to take income away from an already-strained system.
HCI: Jason, the rest you need to add?
Bearden: It is actually a well being fairness problem for us round entry. Once 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, exterior the metro space. We do not immediately profit in any means financially from this program, however the folks we serve do. We care in regards to the folks we serve, and we put folks first. And other people we serve are actually our members, nevertheless it’s folks like Jon, too, as a result of Jon serves a significant position in his neighborhood, not solely offering his neighborhood with high-quality companies, 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 neighborhood, and that’s important to our state’s vitality long-term.
