Provider Relief Funding Helps Underserved Areas Keep Doors Open

January 07, 2021 - Provider Relief Funding through The Coronavirus Aid, Relief, and Economic Security (CARES) Act allowed provider organizations to keep their doors open and supported operational costs, including telehealth, during the height of state lockdowns.

Prior to the pandemic, telehealth coverage was not fully supported by Medicare fee-for-service reimbursement. But the Centers for Medicare and Medicaid Services (CMS) realized organizations needed to leverage telehealth to maintain patient care and sustain revenues at a time when keeping patients out of the provider offices was safest. Flexibilities in once restrictive telehealth policies allowed the care delivery mechanism to explode.

Primary care visits delivered via telehealth grew by nearly fifty percent as providers have been able to treat patients virtually while also being properly reimbursed at levels that allowed them to keep their doors open.

The Provider Relief Fund supported providers in these endeavors as it allocated over $50 billion to Medicare fee-for-service providers for healthcare-related expenses or lost revenue as a result of COVID-19. Additional funding was set aside for Medicaid and CHIP providers including assisted living facilities and application-based funding to providers who reported financial losses or changes in operational expenses as a result of the pandemic.

But a Data Insight from Xtelligent Healthcare Media revealed these payments disproportionately went to medically underserved areas of the country. These areas are designated by the Health Resource and Services Administration (HRSA) as geographic areas that lack access to primary care services, so support for these areas is critical as they are already under-serviced and under-resourced.

The average payment from the Provider Relief Fund was $20,000 more in medically underserved areas than resource-rich environments. In total, medically underserved locations received over $66 billion more in total payments.

While positive that these underserved locations received the funding they needed to keep doors open and maintain revenue levels, it is unclear how much of this funding went to sustainability compared to maintenance.

Was this funding solely allocated to staff to make up the difference in lower telehealth reimbursement rates, or did the funding help support sustainable infrastructure that would allow new telehealth programs to thrive even after the pandemic ends?

The answer to this question will determine if this funding truly did help keep practices afloat or it is was merely a Band-Aid on a much bigger problem. More sustainable funding and infrastructure would support continued telehealth care rather than solving the short-term problem of pandemic relief.

With a second round of relief looming, providers should be mindful of how they use these funds, striking a balance between maintenance and sustainability.  

For a more in-depth look at the analysis from this Data Insight, click here.