Some Chicago hospitals hit hardest by COVID-19 aren't getting any money under a $12 billion federal program aimed at helping hospitals survive the pandemic. Meanwhile, wealthy chains are getting plenty of "high-impact" payments from the fund within the CARES Act.
Loretto Hospital, Norwegian American Hospital and other independent safety nets that treat large numbers of poor and uninsured patients didn't qualify for the payments. Despite full intensive care units, the hospitals didn't admit 100 COVID patients by April 10—an arbitrary threshold and deadline set by the federal government.
But large facilities with deeper pockets like Northwestern Memorial Hospital and Rush University Medical Center cleared the 100-patient minimum, collecting $34.7 million and $33.7 million, respectively, in high-impact funds.
In an effort to reimburse hospitals that have lost money treating large numbers of COVID patients, the U.S. Department of Health & Human Services effectively passed over smaller facilities with limited ICU capacity that have been swamped with coronavirus cases. Often those hospitals also have fewer resources to absorb the costs of treating so many sick people.
"They created metrics that, at the end of the day, benefited all of these wealthy hospitals around the country," Norwegian American CEO Jose Sanchez says. Safety nets "were already at risk pre-COVID, and post-COVID it's going to get worse for all of us. We have nowhere to cut from."
The disparity is going to make it even harder for independent safety-net hospitals that already were teetering on the financial brink to come out of the pandemic intact. Some could be forced to cut services or close, leaving the vulnerable communities they serve without access to medical care.
"Large hospitals and health systems have had serious financial hits, but they do have the financial resources to weather (COVID-19) much more effectively than stand-alone safety nets do," says Larry Singer, director of the Beazley Institute for Health Law & Policy at Loyola University Chicago. "This sort of financial hit can be cataclysmic to some of these stand-alone hospitals."
Norwegian American missed out on a high-impact payment, despite investing in additional ventilators to double the size of its ICU, which has been full throughout the pandemic. Sanchez says he's spent about $1.5 million fighting COVID since mid-March and that the Humboldt Park hospital lost about $600,000 in April.
About 6 miles away in Austin, Loretto Hospital was 15 patients short of collecting a high-impact payment, despite COVID-19 cases accounting for 70 percent of admissions by April 10—after which cases continued to rise rapidly in Chicago.