Continuity Assurance is how rural hospitals keep their ICUs open
Lower rates for hospitals depend on investors’ confidence that equipment will be paid for. Service hold is how we give them that confidence, and we use it rarely.
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Editor’s note: The Overseen reported on Aug. 19 on a service hold at a hospital that finances equipment through Wardmore Health Capital, and invited the company to respond. Opinion pieces reflect the views of their authors, not of The Overseen.
In 2014, when we started Wardmore, the hospitals that most needed new intensive-care equipment were the ones least able to buy it. A 25-year-old ventilator does not announce that it is about to fail. A rural hospital with two weeks of cash on hand cannot replace it when it does.
Our answer was to finance critical-care equipment in ways that match how hospitals are paid: leases, subscriptions and, since 2016, pricing by the occupied bed-hour. Since 2018, our Rural Hospital Program has helped more than 200 rural and independent hospitals keep intensive-care beds open that might otherwise have closed.
None of that is possible without investors. Hospital equipment finance is funded by people who lend against the payments hospitals make. The lower the risk those investors see, the lower the rate a hospital pays.
Continuity Assurance, which we introduced in 2021, is how we lower that risk. Hospitals that enroll their equipment pay lower rates and lower deposits. In return, if an account falls more than 90 days behind and no payment plan has been agreed, enrolled equipment may enter service hold until the account is resolved. Every step before that point is a conversation: we contact a hospital’s finance team at 10, 30 and 60 days, and offer a plan at every stage.
In August, monitoring equipment at a hospital we serve was in service hold for nine hours. No patients were adversely affected. We were not satisfied with how it happened, and we said so. On Aug. 15 we made a commitment that monitoring equipment in use at the bedside will not be placed in service hold, and that commitment is now written into every Continuity Assurance agreement. Hospitals are told in writing, and in advance, before any equipment enters service hold.
Some critics would have us abandon the program. The hospitals that would pay for that are the ones it was built for. Without the confidence Continuity Assurance gives our funders, many rural hospitals would face higher rates, larger deposits or no financing at all. A bed that is never bought helps nobody.
We will keep listening to hospitals, and to their nurses and physicians, about how the program can work better. We will not apologize for building a way for small hospitals to afford the equipment their patients need.