Hospitals Want a Slice of Biden's $2T Infrastructure Plan

AHA President and CEO Rick J. Pollack tells President Biden that the COVID-19 pandemic has crippled the nation's hospitals.

The nation's hospitals want a share of the $2 trillion infrastructure plan put forward on Wednesday by President Joseph R. Biden.

In a letter Wednesday to the president, American Hospital Association President and CEO Rick J. Pollack noted that healthcare is one of the 16 critical infrastructure sectors designated by the Department of Homeland Security, and that the ongoing COVID-19 public health emergency has left hospitals badly strained.

"As your Administration works with Congress to develop policies aimed at rebuilding our nation's critical infrastructure, as reflected in today's announcement, we urge you to prioritize support for healthcare and its vital role in addressing critical challenges including health equity, emergency preparedness, access to care and more," Pollack said.

"The reality is that just as other critical infrastructure, including our nation’s roads, bridges and transit systems, have aged, so too have many of our nation’s hospitals," Pollack said. "Many hospitals faced financial challenges prior to the pandemic, but COVID-19 has brought unprecedented financial losses."

Pollack pointed to AHA estimates that the nation's hospitals lost more than $320 billion in 2020 and would lose as much as $120 billion in 2021 because of the pandemic and the ensuing shutdown of nonessential healthcare services.    

"These compounding financial pressures have resulted in delays in necessary capital spending, including for needed maintenance and physical plant upgrades," he said. "In addition, some hospitals that are in the greatest need of repair have the greatest barriers to accessing capital."

Without providing a specific cost estimate, Pollack offered recommendations for healthcare infrastructure improvements that included:

• Investing in hospital physical infrastructure, including physical plant upgrades, mechanical systems, IT, medical equipment, and supplies. "In addition, hospitals face the added challenge of needing to reconfigure care delivery and “right-size” so that they can continue to transform to meet the needs of the healthcare system for the future in an effort to make care more accessible and convenient for patients," Pollack said.
   
• Building emergency preparedness and response capacity through continued funding and structural improvements for the Hospital Preparedness Program. "The COVID-19 experience reinforces the need for sustained federal investment to support increased capacity for emergency preparedness and response," Pollack said.
   
• Expanding healthcare digital and data infrastructure, including access to adequate, affordable broadband to enable telehealth and increase access to care, particularly for remote and underserved areas, hardening cyber defenses to protect patient privacy,  and modernizing data systems that support identifying issues that affect health equity, racial and ethnic disparities, care quality, and public health responses.
    
• Strengthening the healthcare workforce by increasing the number of residency slots eligible for Medicare funding; funding educational loan pay-downs and vouchers for clinicians and other front-line workers; providing visa relief during emergency response; funding research and demonstration programs related to clinician wellbeing; establishing grants for cultural competency training in medical residency programs and in-service training for healthcare professionals; providing grants to expand, modernize and support schools of medicine and schools of nursing in rural, underserved areas or minority-serving organizations; and rejecting reductions to Medicare funding for direct and indirect graduate medical education.
   
• Securing the supply chain by increasing domestic production capacity and manufacturing redundancy; and reinforcing the strategic national stockpile through continuous investment so that the equipment is available in adequate amounts when it's needed for public health emergencies.
   
• Supporting behavioral health access with funding for new behavioral care sites; renovations to improve safety at psychiatric facilities; end-user devices to upgrade audio-video technology to support behavioral telehealth; therapeutics for children and adolescents, including mobile applications, text messaging, and remote biometrics that can assist in screenings and treatment for behavioral health conditions; and interoperable electronic health records for behavioral health providers.