Alaska’s hospitals are front-line for COVID-19, but they’re feeling the financial pinch too

Images of chaotic emergency rooms lined with COVID-19 patients dominated news images from the Lower 48 in recent weeks.

But in Alaska, where the virus so far has a weaker grip, hospitals have been less than half full for more than a month, according to the Alaska State Hospital and Nursing Home Association.

The low numbers are due to changes to prepare for any future COVID-19 surges, a reduction in elective and outpatient surgeries, and a general drop in hospital visits as people try to stay away, association president and CEO Jared Kosin said.

Small and mid-size hospitals are planning for losses between $2.3 million and $11.4 million from operational declines in April through June, the group says. Larger facilities are bracing for losses in the $40 million to $50 million range.

All told, revenues for hospitals and nursing homes are expected to drop by $70.7 million to $78.3 million a month.

“It crushes your operations,” Kosin said. “Your revenue comes in from people who are using your services. I’m talking about necessary services.”

This is the first week that physicians and dentists could resume elective procedures instead of just urgent or emergency ones. Things are starting slowly. A state count showed just over 860 of the state’s 1,800 inpatient beds were full as of Thursday.

The association’s executive committee, which includes the leaders of 10 facilities around the state, late last month asked Gov. Mike Dunleavy to set aside at least $150 million for grants to hospitals and nursing homes.

On Wednesday, Alaska Health and Social Services Commissioner Adam Crum said state officials are trying to educate federal officials on the state’s unique health care situation.

“There is not a lot of skilled nursing or nursing homes, there are not a lot of hospitals, but they cover a region bigger than Texas,” Crum said.

The state is talking with the hospital association about their financial needs, he said. It’s going to be a process throughout the year “to make sure we keep Alaska’s hospitals up and running."

Federal CARES Act funding for COVID-19 relief is helping. Of about $60 billion initially distributed to health care providers, Alaska received nearly $129 million. That provided $84.8 million to 944 providers, Kosin said. Hospitals got around $44.7 million.

A second $10 billion distribution released last week for rural providers brought another $69 million to the state, he said. It’s unclear how much additional federal aid Alaska’s health care providers will get.

Kosin said his biggest concern is for small, critical-access hospitals that could lose the ability to remain operational.

Alaska’s number of acute-care beds per 1,000 people is among the lowest in the country. Half the state’s hospitals and nursing homes are off the road system, bringing unique access challenges. Alaska also has the fewest nursing homes in the country.

Yukon-Kuskokwim Health Corp. late last month announced four-week furloughs as well as some layoffs involving 300 largely non-provider employees amid monthly losses of $5 million to $8 million. Officials there say they’ve asked Alaska’s federal delegation to extend unemployment benefits through the duration of the coronavirus pandemic.

This week, providers started offering dental and optometry visits, according to Dan Winkelman, the tribal organization’s president and CEO.

“We’ve made a full-court press on telehealth,” Winkelman said. "We’ve seen a slight increase in our outpatient visits here in Bethel because of that."

Still, the hospital remains at half capacity like others around the state, he said. “With the reopening here that might change. Then of course with COVID, as we reopen if there’s an outbreak of that, that’s going to completely change everything I just said.”

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