Fresh sources – Speaker of the House Matthew Shepard said he is concerned about funding for rural health care and hospitals.
“We are taking steps to address the issue, and there are many factors at play,” he said in response to a moderator’s question during the Arkansas Rural Development Conference’s legislative session at the Oaklawn Event Center. .
Shepherd, R-El Dorado, said one reason is that the Covid-19 pandemic has “really changed the world as far as health care goes.”
But the other part of that is that our providers got increased payment rates during the Covid period and now it’s going back and basically they have to make up some of those additional payments. [and] “Now is the time to come and pay back, so it is causing problems especially for our rural health service providers,” he said.
Hospitals received higher Medicare payments earlier during the Covid-19 outbreak and are receiving lower Medicare payments to pay that money back to the federal government, state Department of Human Services officials said.
State lawmakers have appropriated $60 million in funding to help rural hospitals as they face possible closures. So far, only $6 million in federal America’s Rescue Plan funding has been floated to a hospital in Ouachita County.
In September, the Legislature authorized the state Department of Human Services to transfer $6.07 million in federal USA Rescue Plan funds to the Ouachita County Medical Center in Camden to help avert the hospital’s imminent closure.
At that time, the House voted to send a separate request to the Performance Review and Expenditure Review Committee for additional review of $10 million in federal Save America Plan funding at North Arkansas Regional Medical Center in Harrison. Eight other hospitals applied for between $1.5 million and $10 million in federal Rescue Plan funds last fall, and more hospitals are expected to seek funding, Gavin Lesnick, a spokesman for the state Department of Human Services, said Thursday.
“We have $54 million left and what we’ve done with the governor’s office, and I’m guessing,” Shepherd said Wednesday. [the state Department of Human Services] Various hospitals have provided their financial information.
“One of the things we’re looking at is if they’re asking for government funds and those kinds of funds to provide the money we need to look at their books and we need to know number 1, they’re really on. That they need that help and secondly, how they’re doing.
Shepherd said that any time the government provides some assistance, they may not always understand how those jobs will be done and whether something else can be done.
“We’re really looking at it, we’re having ongoing discussions with the governor’s office and leadership on both sides,” he said.
Financial status assessment
Although the state Department of Finance and Administration does not contract with any firms to review applications for federal America’s Rescue Plan funds, the New York-based firm of Alvarez & Marsal was hired in 2015 to review the financial health of several rural hospitals. It would be safe by 2022, department spokesman Scott Hardin said Thursday.
The finance department’s contract with Alvarez & Marsal is for $1,323,655 from Jan. 1, 2023, to June 30, 2023, of which $997,371 has been disbursed to the company to date, he said.
The goal is for the company to submit a final report on the financial status of several rural hospitals to the Legislature next month, Hardin said, but it has not yet been determined whether a request for a new contract with the company will be made. ..
As for the El Dorado hospital, Shepherd said a local group has reached an agreement to buy the hospital in El Dorado. The University of Arkansas for Medical Sciences is going to operate the hospital and the state is providing some help with that.
During this year’s regular session, the Legislature appropriated $12 million in state-restricted reserve funds for UAMS to fund the new Southern Arkansas Regional Hospital in El Dorado. These funds will cover the hospital’s operating costs associated with the purchase and will extend specialty care services in the area, according to UAMS.
“The fact that local dollars are about three to one compared to state investment, and I think at the state and local level, it’s probably going to increase over time,” Shepherd said. We have to.
For example, he said opening the hospital in Camden was especially important because of the defense contracting industry and the jobs in East Camden and the potential for more economic development in that area, but if there is no hospital within 40 miles of those facilities then that could be a concern.
“Concerned is probably not the right word,” Shepherd said of concerns about rural health care and hospitals.
“I think we just have to keep our eyes on it and work with our health care providers to make that sustainable,” he said.
Rep. Howard Beatty, R-Crossett, said, “I think we should all be concerned about the quality or standard of health care in our communities.
“Rural hospitals are currently recovering from the damage that Covid has done to their operations,” he said at the Arkansas Rural Development Conference. I still think that the biggest obstacle we have in rural health care is that it is not used enough by the society, so those of you who are in this department, be encouraging to your rural hospitals and we should work with them; I know we will.
“I think we have strong health care providers in those communities, but there’s pressure on that sector and I think it’s something we have in the Legislature … when they come out,” Beatty said.
Asked if he agrees with some conservatives who say rural hospitals have a cost problem and aren’t spending their money properly, hospital operations have had to change during the Covid-19 pandemic.
“We’ve seen an increase in labor input for hospitals [and] It was the delivery issues that changed the way rural health care was delivered,” Beattie said. Urban area, I think that’s some of the issues.
Paying nurses and traveling nurses to attract and retain staff in rural communities remains a major issue for rural health care, BT said.
“But I think the community is working to address those issues, and I think we’ll find some solutions to work with,” he said.
Meanwhile, Arkansas’ Medicaid program’s beneficiaries are expected to shrink over the next several months, which could hurt rural hospitals.
Medicaid cases are closed.
Earlier this month, the state Department of Human Services reported that the cases of 72,802 Medicaid beneficiaries in Arkansas were closed at the end of April because they either did not return information necessary to determine their eligibility or were no longer eligible for Medicaid.
The closed cases include 44,667 Medicaid beneficiaries whose coverage was previously extended under federal public health emergency special eligibility rules and 28,135 other Medicaid beneficiaries whose coverage was closed as part of routine operations, Lesnick said earlier this month. Reasons for ending Medicaid coverage vary among these groups.
The department said these figures reflect redeterminations of Medicaid eligibility as part of the department’s six-month campaign following the end of the continuous coverage requirement implemented during the federal government’s public health emergency. ..
The continuous coverage requirement prevented the state Department of Human Services from removing ineligibles from Medicaid, but regular eligibility rules resumed April 1, the department said. The requirement is that no Arkansans can be removed from Medicaid rolls until the federal public health emergency ends, and cases can only be closed if individuals move out of state, die, are incarcerated, or request that coverage end. .
The state Department of Human Services is “moving quickly to ensure that Medicaid resources go to beneficiaries who truly need them to enroll individuals who are no longer eligible, and will continue in the coming months as this resolution progresses,” the department said. At the beginning of this month. Medicaid enrollment totaled 1.06 million on May 1 and Medicaid enrollment reached 1.13 million on April 30.
According to the Department of Human Services, Arkansas Medicaid enrollment has increased by more than 230,000 during the COVID-19 pandemic, and “we expect overall enrollment to decline as we review eligibility and will update the numbers on a monthly basis during the process.” “