COVID-19 increased financial strain on NC’s rural hospitals, their leaders say – The Progressive Pulse

NC rural hospital leaders talk about financial challenges

The COVID-19 pandemic has worsened staff shortages in rural hospitals, their leaders said Thursday, with the steps taken to compensate for those shortages contributing to the increased financial strain at their institutions.

After the constant stress of caring for critically ill COVID-19 patients, growing numbers of hospital staff retired, resigned, or left staff jobs to make more money working for agencies where they travel from hospital to hospital.

The stresses that were put on the healthcare systems, especially the rural hospitals, during the pandemic are actually continuing, Dr. James Hoekstra, president of High Point Medical Center, said during a webinar sponsored by the NC Healthcare Association. The hospital in High Point is a part of Atrium Health Wake Forest Baptist. Hoekstra is also on the Alleghany Health board of directors in Sparta.

Rural hospitals have faced financial troubles for years. A lot of the newer money problems come from the high cost to replace workers, Hoekstra said.

We have lost a lot of providers to retirement, he said. Weve lost a lot of providers to going to different areas of the country to travel and earn more money. Weve lost a lot of providers and staff to burnout and what weve been left with is a situation where weve had to hire a lot of what we call travelers or contract labor.

What weve been left with is less staff, more overburdened, and more expensive, he said.

The pandemic had accelerated some changes to healthcare increased use of telehealth medical appointments, for example, that include something called Hospital at Home, for people who are stable but sick enough to be in the hospital but receive care at home. Those patients are monitored electronically, and medical staff visit their homes.

Like most healthcare issues, telehealth is wrapped up in questions about money, specifically, how much it should cost.

A legislative committee on expanding Medicaid and improving access to health care heard presentations on telehealth this week. Chris Evans, vice president for public relations at Blue Cross NC, asked whether insurance companies should be charged facility fees for telehealth visits.

Blue Cross NC saw telehealth claims increase 7,500% in 2020 over the previous year, Evans said, while private insurers nationwide saw a 4,347% increase.

Behavioral health and primary care accounted for 92% of the 2.7 million telehealth visits Blue Cross NC paid for, she said.

The legislative committee also recently heard presentations on the states Certificate of Need law. Companies that want to build new hospitals, nursing homes, dialysis centers and other health facilities, or buy expensive medical equipment, must get permission from the state. Proponents of Certificate of Need laws say they prevent over-building. Critics say the laws stifle competition. Senate Republicans have for years pushed to repeal the states law.

Hospitals fear that repealing the law will result in competitors offering select medical services to people with private insurance, leaving the hospitals to care for patients who are uninsured or use government health insurance plans such as Medicare and Medicaid, which dont pay as much.

Repealing Certificate of Need will increase hospital financial losses and further imperil rural hospitals, Maria Parham Health CEO Bert Beard said during the webinar Thursday. Maria Parham Health, a Duke LifePoint hospital, has a hospital in Henderson and an emergency department in Louisburg.

That will put us under, he said. It will impact us from a workforce standpoint. It will take all the payers that have anything that support our safety net services, and all youll be left with is 24/7 urgent cares.

Dr. Roxie Wells, president of Hoke Healthcare, said legislators could help rural hospitals by applying for a federal program that increases payments for Medicaid patients hospital care. Hoke Healthcare is part of Cape Fear Valley Health.

North Carolina hospitals run a $2.3 billion deficit providing safety-net services to low-income patients, Healthcare Association spokeswoman Cynthia Charles said in an email. The federal program would help make up for part of that loss.

It really doesnt cost North Carolinians anything, Wells said, but it would be beneficial to be able to obtain those funds and use them for fixing outdated buildings, having services, strengthening the workforce and so many other things.

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COVID-19 increased financial strain on NC's rural hospitals, their leaders say - The Progressive Pulse