Patients in OSF HealthCare’s hospital-at-home program were discharged last week after the federal government shutdown caused a key telehealth waiver to expire, an early example of how the shutdown is affecting services in central Illinois.

When asked to comment on how the shutdown could affect services locally, OSF HealthCare said the “most immediate impact” is on its Digital Hospital program, a hospital-at-home model in Peoria that operates under a Centers for Medicare & Medicaid Services waiver through the Acute Hospital Care at Home program.

“The shutdown will have minimal impact for OSF HealthCare for now,” OSF said Friday. “However, the most immediate impact to OSF HealthCare is on the Digital Hospital program.”

Morris Hospital & Healthcare Centers said the shutdown had not yet caused any service disruptions as of last week, but it warned that a prolonged shutdown could create serious financial strain. Medicare accounts for about 22% of Morris Hospital’s revenue, and Medicaid about 3%.

“As a nonprofit community hospital that provides health care services to the community regardless of ability to pay, we do not anticipate cutting or delaying services as a result of the federal government shutdown,” President and CEO Tom Dohm said.

The La Salle County Health Department said it has not been adversely affected by the shutdown so far.

“At this time, the health department has not been adversely impacted. All programs continue to operate normally. The department continues to monitor the situation closely for potential negative impacts, as they can take some time to trickle down to the local level. In conversation with our state partners, [the Special Supplemental Nutrition Program for Women, Infants and Children] is open and operational in Illinois,” the department said.

The shutdown itself is tied to a debate in Washington over health care costs. Democrats want to keep Affordable Care Act subsidies in place past the end of the year and reverse Medicaid cuts, but Republican leaders have not agreed.

Core programs such as Medicare and Medicaid will keep running because their funding is built into law. However, telehealth – a popular Medicare benefit – already has ended for many, and discretionary programs such as Community Health Centers may be at risk unless Congress acts soon.

Telehealth has been a staple in the country for years, providing a convenient way for patients to access their doctors without leaving home. As of Oct. 1, Medicare’s pandemic-era telehealth waivers have expired.

More than 167 million people in the U.S., or about half the population, are covered by the programs, according to data from the CMS.

OSF said that with the expiration of the waiver authority, it is currently not permitted to continue delivering care under its current program model.

“All patients were safely discharged from the program before midnight on Sept. 30, and Mission Partners [employees] working in the Digital Hospital department have been temporarily redeployed to other roles to support care delivery during the shutdown,” OSF said.

Dohm said that if a funding delay does occur, there would be an immediate and direct impact on Morris Hospital’s billing and cash flow, as a significant portion of revenue is tied to these government programs. He added that the biggest risk to rural health care is the disruption and potential loss of essential federal funding, which could push hospitals already operating on thin margins into a bad place financially.

“If Medicare and Medicaid payments are delayed, hospitals may be forced to access their cash reserves to cover routine operational expenses,” Dohm said. “If the delay is prolonged, these reserves could become depleted … potentially resulting in a hospital closure or reduction in services that would make health care less accessible for rural residents in northern Illinois.”