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 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 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 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. May you discuss concerning 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 have now 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 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 will do via this partnership will actually facilitate stabilization of that rural hospital ecosystem, and hopefully we’ll get out of that third-highest nation hospital closure charge.

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

Bearden: The obvious influence is the entry points that we see. Lots of our rural hospitals during the last 20 years have opened up OB/GYN items the place mothers might 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 providers which might be obligatory 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 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 advised me that quite a lot 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 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, might you discuss concerning the the state of affairs that Taylor discovered itself in, in order that one thing like this program would show helpful? 

Inexperienced: With COVID, labor and provide prices, the whole lot simply went considerably greater. 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 quite a lot 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 manner 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 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 quite a lot of price in rural medication. I believe we made this association in two days or one thing like that, and obtained us what we wanted, and that helped us alongside for a number of 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 following 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 similar 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 actually do. I believe that except one thing totally different occurs, that is in all probability the trail that the majority hospitals should take throughout the subsequent 5 years. We don’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 below 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 referred to 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 have a look at that?

Inexperienced: Are you aware, we really did have 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 commentary beds, however you lose ICU beds. Anybody healthcare will let you know this — it’s important to 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 essentially 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 need to add?


Bearden: It is actually a well being fairness difficulty for us round entry. Whenever you have a look at rural vs. city, the entry actually breaks down while you get out into the southern and northern elements of Georgia, outdoors the metro space. We do not immediately profit in any manner financially from this program, however the individuals we serve do. We care concerning the individuals we serve, and we put individuals first. And other people we serve are definitely our members, however it’s individuals like Jon, too, as a result of Jon serves an important 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.