Payer CareSource Affords Financing Assist to Rural Georgia Hospitals

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 residence amenities 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 important 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 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 speak 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 feel 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 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 had been staved off throughout 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 are able to do via 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 influence 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 may keep of their communities and have their baby 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 companies which are essential for triage and stabilization dry up. These are among the most evident access-to-care points. However I feel 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 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 concept 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 may not be capable 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 government director instructed me that a variety 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, however it’s only a time window hole.

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

Inexperienced: With COVID, labor and provide prices, all the things simply went considerably increased. You may 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 nicely. We began brainstorming on how we may determine a means to assist, at the least in small interim areas, to stabilize the hospitals once they get right into a state of affairs the place they’re confronted with probably door-closing points. 

We needed to guarantee that we made payroll, as a result of generally our business funds are available in slower. After we offer the companies, we’re up-fronting a variety of price in rural medication. I feel we made this association in two days or one thing like that, and acquired us what we wanted, 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 following day or two, and began placing them in contact with CareSource to assist them in comparable conditions.

HCI: In different states, we’ve got seen examples of smaller group hospitals and rural hospitals getting bought or changing into associates of enormous, built-in well being techniques similar to tutorial medical facilities. Is {that a} risk for a few of these smaller hospitals in Georgia? 

Bearden: Over the past 5 years, the large 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 actually do. I feel that until one thing completely different occurs, that is most likely the trail that almost all hospitals should take inside the subsequent 5 years. We shouldn’t have the negotiation energy with contracts like bigger techniques do. We may nonetheless stay Taylor as a part of a much 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 feel required hospitals to surrender their acute care beds, however they’d stay open as emergency amenities. 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 regarded like, after which we determined to tug again. You lose all of your inpatient beds, proper? You may nonetheless have commentary beds, however you lose ICU beds. Anybody healthcare will let you know this — you must have switch agreements with different hospitals. Even now, with the very small variety of rural emergency hospitals within the state, you nearly can’t discover an ICU mattress to switch a affected person to. So you are taking 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, the rest you wish to add?


Bearden: It is actually a well being fairness situation for us round entry. Once you have 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 immediately profit in any means 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 other people we serve are actually our members, however it’s individuals like Jon, too, as a result of Jon serves a significant position in his group, not solely offering his group with high-quality companies, however being an employer of observe. 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.