June 15, 2020 - Douglas Myser

Small hospitals bilked part two. Representatives of the American Hospital Association, a lobbying group for the country's largest hospitals, communicated with Alex M. Azar, the department secretary, and Eric Hargan, the deputy secretary overseeing the funds. Chip Kahn, president of the Federation of American Hospitals, which lobbies on behalf of for profit hospitals, said he too, had frequent discussions with the agency. The department then devised formulas to quickly dispense with billions of dollars to thousands of hospitals--and those formulas favored large, wealthy institutions. One formula based allotments on how much money a hospital collected from Medicare last year, Another was based on a hospital's revenue. While Health and Human Services also created separate pots of funding for rural hospitals and those hit especially hard by the coronavirus, the departments did not take into account each hospital's existing financial resources. Small hospitals bilked part two.

"This simple formula used the data we had on hand at that time to get relief funds to the largest number of health care facilities and providers as quickly as possible," said Caitlin Oakley, a spokeswoman for the department . While other approaches were considered, these would have taken much longer to implement." Hospitals that serve a greater proportion of wealthier, privately insured patients got twice as much relief as those focused on low income patients with Medicaid or no coverage at all, according to a study this month by the Kaiser Family Foundation.

"If ever you hear a hospital complaining they don't have enough money, see if they have a venture fund," said Niall Brennan, president of the nonprofit Health Care Cost Institute and a former senior Medicare official. "If you've got play money, you're fine." In a letter this month to the Department of Health and Human Services, two House committee chairmen said the Trump Administration appeared to be disregarding Congress's intent in how it was distributing the aid. "The level of funding appears to be completely disconnected from need," wrote two Democrats.