Hi, Atlanta!

Georgia is set to receive nearly $219 million this year as part of a federal initiative to transform rural health. The funding is part of the Rural Health Transformation Program established by Congress and President Donald Trump that will funnel $50 billion to states over the next five years. 

Georgia’s plan for the funds includes some ambitious goals, including decreasing deaths in rural areas by 15% and increasing the ratio of rural health care providers to population by 20% by 2031. 

State officials are still working out the details of how the funds will be allocated, but here are a few ways they said they’d use the funds in the 96-page application they submitted this fall:   

• Help rural hospitals purchase new ambulances to improve the speed at which patients can be transported

• Increase capacity at the state public health lab in Waycross to speed up processing of newborn screenings 

• Help low-income pregnant women who are overweight access dietician support, case management, and weight-loss drugs with the goal of decreasing maternal deaths 

• Set up a system where health care students and others provide care via mobile units and telehealth pods

• A host of programs to bolster the state’s health care workforce, including scholarships for people training for EMT jobs who agree to work in rural communities; summer camps to encourage young people to become nurses; and support for nurses to obtain advanced degrees who can, in turn, help train more nurses 

But don’t look to the funding to solve the state’s rural health crisis, said Leah Chan, the director of health justice at the Georgia Budget and Policy Institute. Hospitals and medical providers are set to lose a significant source of revenue starting in 2028. That’s because the same bill that created the Rural Health Transformation program will phase out a program that provided crucial payments to hospitals and health care providers operating on thin margins. 

The Directed Payments Program, also sometimes called the State Directed Payments program, helps pay medical providers and hospitals a higher rate for care for Medicaid patients. Medicaid typically has the lowest reimbursement rates among all health insurance plans, and this program helps hospital and health care providers that serve low-income Medicaid patients make ends meet. 

An analysis from the Georgia Health Initiative and health care consultancy Manatt Health Strategies found that the changes will result in a $5.4 billion loss in revenue for hospitals over the next decade, with rural hospitals losing $626 million due to this and other changes. 

That loss could result in more rural hospitals closing, said Chan, adding “fuel to what is already a smoldering fire here in Georgia.”

Chan said the effects could be felt sooner than later, even if 2028 seems a long way off. That’s because hospitals are looking ahead to the loss of the payments while anticipating an increase in the number of patients who can’t pay for care, in part because subsidies for Affordable Care Act insurance expired last month. 

A case in point could be the October closure of the labor and delivery unit at the St. Mary’s Sacred Heart Hospital in Lavonia, which the hospital attributed in part to Medicaid cuts by Congress. 

“It is going to be a very drastic reduction in the supplementary payments that we've been able to pull down for these hospitals,” Chan said. 

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