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Why the Infrastructure Deal and American Rescue Plan Are Life Buoys for Floundering Hospitals


Baha Zeidan, CEO of Azalea Health, gives his take on the infrastructure legislation and the benefits it can provide for patient access to quality care, especially in traditionally underserved communities.

With President Biden’s signature this past November, the Infrastructure Investment and Jobs Act, or the Bipartisan Infrastructure Deal, finally made its port of call in the U.S. In doing so, it immediately began offloading its cargo of more than $1 trillion in spending designed to raise the tide on which the prospects for a better quality of life for all in this country float.



While the infrastructure deal doesn’t explicitly earmark dollars for the U.S. healthcare system, a good deal of spending will directly contribute to patient access to quality care, especially in traditionally underserved communities. That’s because most of the money will fall into one of two categories: helping people move to the things they need (investing in roads, bridges, public transit and passenger rail) or moving needed things to where the people are (delivering clean water to American households and fortifying the supply chain by improving sea and air ports, etc.). Facilitating movement is largely what infrastructure is all about, and that includes helping people get to the care they need.

The Bipartisan Infrastructure Deal establishes as one of its primary goals extending broadband access to all Americans. This, too, is incredibly important for the healthcare system, given that the COVID-19 pandemic triggered a shutdown of so much physical movement. The only way that hospitals could replace some of the revenue lost when elective procedures were suspended and so many patients stopped seeking routine and non-emergent care was to rapidly introduce and/or scale telehealth services.

Hospitals that had previously invested in a proper telehealth technology solution may have had an easier time with revenue replacement than those facilities that had not yet incorporated a telehealth component in their patient services. While a rapid shift to telehealth was absolutely necessary, such a new tack remained an incredibly risky proposition for hospitals everywhere, not the least of which were those serving rural communities where broadband access is virtually non-existent.

Back in 2020, no one knew whether telehealth at scale was going to work as well as it has. During these periods of suspension of in-office services, patients’ virtual access to care through telehealth has often been just as limited as their physical access, particularly in rural areas. Taking a “build it and they will come” approach to telehealth was extremely difficult for rural hospitals serving regions of the country that don’t have the virtual infrastructure that can move the care to the people who need it.

With as many as one quarter of all rural hospitals being on the verge of going under even before the pandemic began overwhelming the U.S. healthcare system, there hasn’t been much in the way of discretionary funds available to spend on innovative care delivery vessels like HIPAA-compliant telehealth solutions. So when the Centers for Medicare and Medicaid (CMS) temporarily relaxed the technology requirements around acceptable communications platforms for telehealth, many hospitals opted for temporary solutions like the popular virtual meeting platforms through which to conduct telehealth appointments.

However, in March of 2021, the Biden administration cast out the first of its life rings in the form of the American Rescue Plan (ARP), which, unlike the Bipartisan Infrastructure Plan, provides COVID relief in the form of direct funding to those who can demonstrate negative impact from the pandemic. The Biden administration is allocating more than $8.5 billion in ARP funds to help health care providers in rural areas cover costs associated with COVID-19 to keep their doors open, expand the workforce and train new rural healthcare providers to support broader implementation of electronic health records (EHRs) and telehealth.

Putting cash directly in the hands of those affected by the pandemic and giving them the autonomy to decide how best to spend the dollars is empowering. Combining this relief with infrastructure funding that emphasizes ensuring broadband access for all Americans is life-saving for rural hospitals that have been bailing madly over the past two plus years just to stay afloat.

As CMS is exploring how best to make telehealth a permanent care delivery mode, hospitals everywhere would be wise to tap ARP dollars to modernize their own technology infrastructure. By investing in cloud-based IT architectures (vs. traditional on-premises servers), including HIPAA-compliant telehealth solutions, healthcare providers can reduce overhead costs in the long term while gaining new efficiencies in care delivery through telehealth, patient engagement, and revenue cycle management integrations.

When revenue is only coming in at a trickle, there’s little opportunity to do anything more than sink or swim, spending as little as possible to keep existing systems running, regardless of how outdated or inefficient they may be. The ARP opens the spigot to help rural hospitals ride a new wave of virtual healthcare management and delivery. COVID-19 has been a tempest, but with the Bipartisan Infrastructure Plan shoring up patient access to these new cloud-based solutions, hospitals should jump in. The water’s fine.

Baha Zeidan is CEO of Azalea Health.

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