Committed to improving the health and well-being of all people across every state.

Follow the Money – A Template for States to Track Federal Relief Funds by Hospital

Updated June 12, 2020

Last week, states received a minimum of $1.25 billion from the Coronavirus Aid, Relief, and Economic Security Act (CARES Act, Title V) to use at their discretion to address issues related to the pandemic. These dollars may be used to fund necessary COVID-19-related expenses that have not been addressed in their most recently passed state budgets and are limited to expenses that occur between March 1 to Dec. 30, 2020.

To make funding decisions amid many competing priorities, states could benefit from a snapshot showing all federal coronavirus relief funds that have already been received by hospitals and their affiliates within their states. It remains unclear if and when the federal government will make such information available and whether that data will be by hospital.

States need this information now to make equitable decisions in parsing out the new Title V funds and to ensure that adequate pandemic-related funding is available to safety net providers and others in great need. Importantly, the initial $50 billion sent to hospitals by the federal government was allocated on a formula based on Medicare fee-for-service payments, which leaves out a substantial number of providers.

In a recent letter to the Department of Health and Human Services (HHS), the Medicaid and Children’s Health Insurance Program (CHIP) Payment and Access Commission (MACPAC) identified the shortcomings of using Medicare data to base CARES Act hospital allocations. For example, those reimbursements do not generally account for important state providers, including those providing non-hospital-based mental health and substance use disorder services and home- and community-based care and pediatric services, all of which have been affected by the pandemic and serve significant numbers of each state’s Medicaid enrollees.

States can use or revise this downloadable template to capture how much in federal coronavirus relief funds each hospital has received to date to guide states’ future CARES Act.


This recently-updated NASHP chart details the amounts and required oversight of COVID-19 federal funds allocated to hospitals, providers, and states by the Families First Act, the CARES Act, and HR 266.

The National Academy for State Health Policy (NASHP), in consultation with state officials, has drafted a template that states can use or revise to seek timely information detailing which hospitals are already receiving federal coronavirus relief funds. The template seeks information about hospitals and their affiliates, which can include labs, physician practices, rural health and behavioral health clinics, surgery centers, and nursing homes.

Because the initial funding went directly to hospitals and not health systems, the NASHP template identifies funds received by individual hospitals. The template recognizes that hospitals are under great pressures and as a result is designed for ease of reporting. It is structured to facilitate speedy information gathering to assist governors and state legislators target newer federal relief funds as effectively and as soon as possible.

States, confronted with sharp revenue declines and a likely future of challenging budgets, need to make tough decisions about apportioning the new federal funds at their disposal and about future budget allocations. This template is designed as a “quick hit” to determine which hospitals – and other providers affiliated with them – are getting funding and how much each is receiving now and over the next months as new federal relief fund disbursements continue.

Governors may wish to issue executive orders or require hospitals to report their federal relief funding to date, using such a template, as a condition when requesting Title V funding in order to ensure the state has complete information about current spending before allocating additional dollars. Importantly, this template has a limited application to provide a snapshot of what facility is receiving new federal dollars now.

It does not assess hospitals’ remaining needs or shortfalls, nor how much hospitals presently have in reserves because data about those reserves are included in retrospective hospital-audited financial statements and does not include any hospitals’ expenditures from their reserves during the pandemic. Governors may wish to also ask hospitals to document information about shortfalls and needs prior to allocating new dollars.

NASHP will soon release model hospital transparency legislation and additional tools designed to provide more specific information about the financial condition of a state’s health care system. For now, this template can provide policymakers with a model from which to gain insights into which hospitals and their affiliates are receiving federal pandemic relief funds to help them make decisions about allocating CARES Act Title V funding.

Search

Sign Up for Our Weekly Newsletter

* indicates required
Please enter a valid email address.
Areas of Interest