Member Value Report 2020

Response, Resilience, Recovery: HAP Value in a Pandemic Year

A century ago—during another worldwide pandemic—Pennsylvania’s hospitals came together to form what later would become The Hospital and Healthsystem Association of Pennsylvania (HAP). As the world endures another sweeping virus that has upended every facet of life, the value of the hospital community’s association is drawn into sharper focus.

During 2020, hospitals across the commonwealth shaped their preparations for—and response to—the COVID-19 pandemic with professionalism and agility, and with HAP proudly by their sides. HAP kept its finger on the pulse of an ever-evolving situation, providing logistics support, producing real-time updates and education about new information and guidance, and positioning hospital voices front and center in communications and advocacy outreach.

Throughout the year, HAP reinforced the hospital community’s political influence to ensure that member issues and needs remained top of mind for government decision-makers. Despite deep financial strain in governments at all levels, HAP strongly advocated for supports resulting in a total of close to $8 billion in loans, financial supports, and resources to bolster hospitals’ pandemic response.

HAP Resources for members during 2020

Crucial federal and state resources to support Pennsylvania hospitals in the COVID-19 response

Nearly $2.8 billion through the Federal Provider Relief Fund

$4 billion in Medicare Accelerated Payments

$50 million to purchase medical equipment and supplies

$10 million in additional payments designated for Critical Access Hospitals

$450 million state hospital loan program

$1,758,777 distributed in HHS ASPR funds for PPE purchases

$4,365,487 in the pipeline for ongoing hospital preparedness during 2021

The Value of Advocacy during 2020

Regulatory relief

  • Leveraged nearly 100 regulatory, licensure, and financing waivers to support flexible staffing, increase surge capacity, and expand telehealth—laying the foundation to make telehealth permanent
  • Improved occupancy survey process by urging DOH to implement new attestation form, which now streamlines pathway for hospitals to bring new services and equipment on line

Clinical leadership

  • Mobilized the exceptional talent and deep clinical expertise of our members for input on key decisions, such as crisis standards of care, guidelines for resuming scheduled surgeries, Remdesivir and emerging therapies allocation, vaccine distribution, and COVID-19 resurgence capacity management

Fair hospital payment

  • $70 million protected in a state budget for hospital priorities; fully funds trauma centers, burn centers, and obstetric and neonatal intensive care units; increases funding for critical access hospital
  • $150 million in additional benefit through the Quality Care Assessment
  • $254.6 million in crucial resources protected by eliminating the reduction in the Pennsylvania federal DSH allotment for 2021 and delayed a 75 percent reduction in funds available to the state for 2022 and 2023
  • $180 million in relief from ongoing sequestration cuts

Advocacy in action 

  • Secured legislation to protect the health care workforce by increasing the penalty for assault on a health care worker and allowing facilities to omit the last name from name badges
  • Mobilized grassroots campaigns to support state financial advocacy, retaining flexibilities, COVID-19 liability protections, and accelerated payment loan forgiveness
  • Forestalled wrong-headed policies: state false claims act, duplicative outcome-based performance measures and imposing fees on newborn screening
  • Partnered with AHA to advocate delayed payment cuts, adding new GME slots, expanded telehealth, and surprise balance billing policy consensus

Responding to the Crisis


  • January 27:  HAP emergency management (EM) team activates for COVID-19 event
  • January 29:  HAP begins regular COVID-19 public information and EM calls


  • February 2:  HAP EM staff Department of Health’s Operation Center
  • February 7:  HAP convenes COVID-19 preparedness webinar


  • March 6:  Pennsylvania announces first presumptive positive case of COVID-19
  • March 13:  President Trump declares COVID-19 national emergency
  • March 18:  HAP submits initial request to Wolf Administration, General Assembly for COVID-19 resources, funding, and regulatory flexibilities
  • March 20:  HAP, hospital community advocate for federal priorities in third COVID-19 relief package
  • March 25:  General Assembly passes COVID-19 relief package
  • March 26:  HAP, HAPevolve announce partnership with PA Life Sciences, PA Chamber, state agencies for supply chain support


  • April 5:  HAP Board approves aggressive financial ask to secure necessary state budgetary resources
  • April 13:  Department of Health releases interim Crisis Standards of Care, co-written by HAP
  • April 20:  HAP releases first Health Management Associates (HMA) study projecting COVID-19’s financial impact on PA hospitals
  • April 21:  HAP Board unanimously approves Special Task Force recommended guidelines for resuming scheduled services
  • April 22: HAP issues recommendations for safely resuming scheduled services
  • April 28:  HAP Board approves funding for a public advocacy campaign


  • May 4:  HAP testifies at joint state Senate committee hearing about reopening of Pennsylvania
  • May 5:  HAP releases safe resumption of scheduled services forum
  • May 11:  HAP Board discusses distribution of Remdesivir
  • May 12:  Launched Pennsylvania Health Care Heroes initiative
  • May 22:  HAP submits Remdesivir panel recommendations to Department of Health
  • May 28:  General Assembly allocates first round of CARES Act funds; HAP joins Pennsylvania Coalition for Civil Justice Reform to call for COVID-19 liability protections for hospitals


  • June 3:  HAP issues statement about institutional racism, civil unrest; elevates hospital statements 


  • July 10:  HAP and more than 100 organizations pen letter to Congressional leaders advocating for enhanced FMAP
  • July 13:  HAP launches hospital safety campaign


  • August 3:  HAP participates in state Senate Republican Policy Committee about rural hospital challenges during COVID-19; HAP joins effort to petition Congress for liability protections


  • September 1:  HAP empanels COVID-19 Data Reporting Advisory Committee
  • September 8:  HAP releases follow-up to HMA financial report demonstrating a $5 billion shortfall in operating margins through the end of July
  • September 10:  HAP participates in state House Republican Policy Committee hearing about COVID-19 impacts
  • September 25:  HAP submits COVID-19 Data Reporting Advisory Committee recommendations
  • September 30:  HAP Board examines state false claims act legislation


  • October 2:  HAP solicits input from clinical leaders on COVID-19 vaccine planning


  • November 12:  HAP convenes COVID-19 Second Wave Mitigation Task Force to address capacity management
  • November 13:  HAP Board approves COVID-19 Resurgence Escalation Framework; HAP submits to Department of Health
  • November 20:  State passes 2020–2021 state budget; HAP reinforces hospital capacity capabilities and strategies in report to Governor
  • November 25:  HAP releases COVID-19 mitigation public Call to Action signed by more than 400 hospital doctor and nurse leaders


  • December 3:  HAP Board discusses regional resurgence issues
  • December 17:  HAP releases first COVID-19 mitigation public service announcement
  • December 23:  HAP engages clinical leaders to inform policy conversations about Phase 1A vaccination

Supporting hospital teams infographic

Ongoing Challenges

Work on your behalf continued on a number of other fronts including:

  • Joint State Government Commission issued report titled “Behavioral Health Care System Capacity in Pennsylvania and its Impact on Hospital Emergency Departments and Patient Health” that includes recommendations that support many of HAP’s advocacy priorities
  • HAP’s Opioid Learning Action Network helped 124 hospitals adopt evidenced-based practices to prevent overdoses and help patients recover
  • HAPevolve delivered health care solutions and consulting nationwide; partnered to support the Regional Response Health Collaboration program; provided tailored supports to hospitals and county government; and launched PREP, a web-based platform for emergency plan communication
  • Concluded the Hospital Improvement Innovation Network—94 participating hospitals recognized 3,735 harm events avoided, a cost avoidance of $73,402,276, and an estimated 503 lives saved over the course of the three-year contract

HAP 2021 Advocacy Priorities

We have a full slate of advocacy priorities for 2021. HAP shall seek to:

  • Retain flexibilities relating to hospital and practitioner licensing, billing, and telemedicine
  • Safeguard investments in existing government funding, prevent changes to the QCA which result in net loss of funding
  • Maximize support for hospitals in supplies and vaccination resources, supplemental hospital payments, and behavioral health crisis resources
  • Help you stay on top of the very latest developments with updates related to vaccine distribution, utilization protocols and supply chain

Learn more about HAP’s policy goals.

HAP's Strategic Plan

Vision for the Future

As the country ushers in a new president during a time of tumult and uncertainty, HAP will remain members’ steadfast partner, guiding hospital leaders through new challenges. HAP will continue to be a key voice in Washington, D.C., and Harrisburg, underscoring the importance of applying lessons from COVID-19 to make permanent some of the innovations that hospitals have employed during their response.

Guided by HAP’s 2021–2023 Strategic Plan, HAP will:

  • Boldly advocate and build political support for hospitals and health systems and the communities they serve
  • Accelerate the availability of a plentiful, well-trained, and resilient health care workforce
  • Harness next-generation collaboration and deliver information resources to collectively reimagine and improve health care

Download HAP's 2020 Member Value Report.

Want to learn more about HAP’s value to you?

Contact HAP President and CEO Andy Carter for more information.