Why federal money for Pennsylvania rural hospitals went to UPMC, other urban facilities

Many urban hospitals in Pennsylvania, including facilities in the UPMC network, received millions of rural payments from the American Rescue Plan, the Pittsburgh Post-Gazette reported Dec. 6.

Of the $288 million in funding that went to 96 Pennsylvania hospitals, a little over half was given to 38 rural hospitals. The remainder went to urban hospitals.

Specifically, of the $288 million distributed in November, Pittsburgh-based UPMC received $67 million, or about a quarter of the funds, according to the report.

UPMC said that this allocation is not surprising because it is the largest provider in Pennsylvania and has more rural hospitals than any other health system in the state, with 10 locations. But UPMC Presbyterian Shadyside — which is not in a rural community — received one of the largest payouts with $6 million.

"Since UPMC is the largest provider in the Commonwealth, with a high percentage of rural residents, it only makes sense that UPMC would be the recipient of a higher amount of ARP Rural payments," UPMC spokesperson Susan Manko told the Pittsburgh Post-Gazette.

The reason much of the money went to hospitals in urban locations is because the money is designated for providers serving Medicare, Medicaid and Children's Health Insurance Program patients who live in rural areas, regardless of where the facility is located. UPMC also said that the payments to its facilities were based on claims data from 2019 and 2020, and healthcare organizations didn't provide this data in their applications for the rural hospital aid. Instead, HHS used existing claims data.

The payouts to the urban facilities raise questions about if the COVID-19 relief aid is going to the facilities that need it the most, the Pittsburgh Post-Gazette reported. This is not the first time questions have been raised about distributions of federal COVID-19 aid. In April, The Washington Post published an article suggesting COVID-19 provider relief funds enriched wealthy hospitals and didn't target rural facilities. 

"In an ideal world, from our perspective, all of the money would have gone to rural communities because there really is such a need just to keep [rural hospital] doors open," Carrie Cochran-McClain, chief policy officer of the National Rural Health Association, told the Pittsburgh Post-Gazette. "We are hopeful that the next wave of provider relief funds — Phase 4 — will provide more. More is definitely needed in these rural communities."

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