COVID-19 relief aid fell short for hospitals with low margins, those treating underserved: 8 things to know

HHS' approach to distributing COVID-19 provider relief funding through February 2021 was a hit and miss when it came to health equity, according to a September study published in Health Affairs. 

For the study, researchers from Cambridge, Mass.-based Harvard University sought to measure how COVID-19 hospital relief aligned with the burden of the pandemic across racial, ethnic and social lines. The sample size included $69.5 billion in relief aid received by 2,709 hospitals through February 2021. The sample size represented just under half of the known provider relief disbursements. 

Eight things to know:

1. Hospitals serving areas with a high share of Black residents, those that reported the highest ratio of Medicaid revenue per bed and those with a high number of nursing home beds saw a meaningful increase in federal relief funding.

2. Hospitals serving a high proportion of Hispanic residents and those that had low ratios of Medicaid revenue per bed saw lower relief funding through February 2021.

3. Serving a high population of uninsured patients was not associated with increased or decreased funding, nor was serving an underserved area, according to the researchers.

4. Additionally, having an operating margin of less than -10 percent was not associated with significant increased relief during the study period.

5. The average amount of relief funding each hospital received was $25.7 million, of which $7.1 million was high-impact funding. 

6. Only 20 percent of the 2,709 hospitals received relief through a revenue-based funding allocation. A majority received their relief from a separate allocation, like the rural, high-impact or safety net funding pools. 

7. Researchers said the net patient revenue explained 45.9 percent of the variation in relief disbursement.

8. "Our results confirm that hospitals serving very low shares of people with employer-sponsored insurance were indeed disadvantaged," the researchers wrote. "Future approaches to extraordinary relief should integrate measures of community need from outside Medicare data."


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