While the $50 billion Rural Health Transformation Program has left many with questions on if, when and just how much funding they will receive, the program has won over some skeptics.
Kurt Forsyth, president of Salt Lake City-based Intermountain Health’s Delta (Utah) and Fillmore (Utah) Community Hospitals, said his view on the funds has changed since June.
“I didn’t feel like this money was going to be accessible or really be helpful,” Mr. Forsyth said during a panel at Becker’s CEO + CFO Roundtable. “My opinion has changed. I really feel that there are good intentions behind this funding.”
Mr. Forsyth said he feels like leaders can get stuck in connecting the funds to replacing Medicaid dollar losses, but once they can break away from that and look at it as an opportunity to do things they have not done before, it could be helpful.
One of the things that made Mr. Forsyth a “believer” in the funds was a $200,000 award for Delta and Fillmore Community Hospitals to start a community paramedics program. Ambulance services are run by the county his hospitals serve, with only volunteer emergency medical technicians and around two full-time employees.
“Our dollars are basically being transferred to them to help support some of that hiring of paramedics, but there is a sustainable path forward with that because they will be able to bill at a higher rate for every ambulance run, both in the county and outside the county,” he said. “That one I’m very excited about. I think it is going to add benefits to the people who live in the community.”
In North Carolina, the state received about $213 million in the program’s first year. Dev Sangvai, MD, secretary of the North Carolina Department of Health and Human Services, said the state is trying to figure out how to repurpose existing dollars.
To do this, he pointed to three areas of focus: sustainability, innovation and collaboration.
“We all know that healthcare is local, but rural healthcare is even more local,” he said. “We’ve got to come up with models that are collaborative. Inevitably these dollars go to recipients and subrecipients, and some of them are well-established programs and services, but they are those that continuously rely on grant funding or philanthropic dollars to keep going. We need to figure out how to collaborate across the state so we don’t just create more asks and more needs, much the same way.”
Tiffany Means, CEO of Eureka Springs (Ark.) Hospital, applied for the funding independently and received nothing. However, the hospital gained about $100,000 through a telemedicine effort from Little Rock-based University of Arkansas for Medical Sciences.
“I had a mentor tell me a long time ago, if you’re going to build programs, you have to build those programs as if you were going to ask for zero dollars,” she said. “You take those zero dollars, you build your program, and then if you’re able to get funds off those, that helps accentuate your program.”
For Julie Yaroch, DO, president of ProMedica Charles and Virginia Hickman Hospital in Adrian, Mich., the top priority is workforce, and said areas such as AI and infrastructure are simply tools.
“Without people, we can’t deliver care,” Dr. Yaroch said. “I can have a robot, I can have ambient listening, but if I don’t have the people on the other side to actually use those tools and deliver the care, then none of those efforts really make a difference in access.”
Dr. Yaroch said the one-year spending window for the funds makes it difficult if they are not guaranteed to get funds for years two and three of the program, making it a “high risk” for some rural hospitals.
Dr. Yaroch also said lasting change depends on payers.
“I’m hoping that this process evolves over the years,” she said. “Bottom line is that we’ve got to really be putting pressure on our payers to pay for all this innovation that we’re going to invest in over the next five years, so that we can sustain it.”
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