An exception to the rule: After losing its hospital in 2017, Adel, Georgia, gained a replacement in January 2020. But the new facility lacks an emergency room, which was a financial drain on the old hospital. (AP Photo/ Sudhin S. Thanawala)

To prepare for a surge in patients, government officials have asked health care providers to stop doing elective procedures, causing layoffs and putting rural health clinics at serious financial risk.

Laid-off providers could ostensibly be brought in to hospitals to help with a surge in patients suffering from COVID-19. But those transitions take time. In some cases, time is something hospitals don’t have. 

“It’s fairly consistent across the country that rural health clinics are facing dire economic conditions,” said Brock Slabach, senior vice president for member services with the National Rural Health Association. “People are canceling appointments. That puts huge economic distress on clinics, forcing them to lay-off providers and reduce their budgets even further.”

Slabach cited the case of one town, Lutcher, Louisiana. A hospital there, he said, had 25 patients come into the emergency room at the same time, all suffering from effects of the coronavirus. The hospital had to take care of them, as well as the other patients already at the hospital. 

“If the laid-off workers are registered nurses or physician’s assistants, their skills would certainly transfer over to a hospital setting. It would just take time to move them into those positions when they’re needed,” he said.

Slabach said that, surprisingly, very little of the $2.2 trillion economic stimulus package will go directly to health clinics. 

“There are some provisions, but my suggestion for clinics would be to use the Small Business Loans that the stimulus package is funding,” Slabach said. He said other provisions in the bill will help health clinics pay for unreimbursed costs, as well as to bill Medicaid as a telehealth provider.

According to a summary of the bill by the American Society of Addiction Medicine, the bill provides: 

  • $100 billion for a new program to provide grants to hospitals, public entities, not-for-profit entities, and Medicare and Medicaid enrolled suppliers and institutional providers to cover unreimbursed health care-related expenses or lost revenues attributable to the public health emergency resulting from the coronavirus. This funding will flow through the Public Health and Social Services Emergency Fund.
  • $275 million for the Health Resources and Services Administration (HRSA), including $90 million for Ryan White HIV/AIDS programs and $185 million to support rural critical access hospitals, rural tribal health and telehealth programs, and poison control centers
  • Expansion of Medicare telehealth authority to remove a restriction that limits telehealth coverage during the COVID-19 emergency period to situations where the physician or other professional has treated the patient in the past three years. This will enable beneficiaries to access telehealth, including in their home, from a broader range of providers, reducing COVID-19 exposure. The bill also allows for Federally Qualified Health Centers and Rural Health Clinics to serve as a distant site (where the clinician is located) for telehealth consultations for Medicare beneficiaries.

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