Jason Semprini Poster

Did non-metro healthcare organizations disproportionately benefit from the United States Paycheck Protection Program (PPP) During the Covid-19 Pandemic? Identifying the differences between metro and non-metro loan recipients in the healthcare sector

Jason Semprini, MPP, University of Iowa


twitter handle: @SempriniJason

Jason Semprini is an NIH predoctoral fellow at the University of Iowa College of Public Health and College of Dentistry. After completing four years of Americorps service and two years of Peace Corps service, Jason received his Master’s in Public Policy at the University of Chicago. A lifelong Iowan, he now lives in Iowa City with his wife and two-year old daughter.

Learning objective:  Participants will be able to list the differences in CARES Act Paycheck Protection Program participation between rural and non-rural healthcare organizations.

Click here to open the full poster or below to read the abstract

  • Background: In the early weeks of the covid-19 pandemic, escalating costs, combined with the loss of billions in revenue, motivated United States policymakers to include healthcare organizations in the Paycheck Protection Program. This study aimed to identify the differences between non-metro and metro healthcare program participants.
  • Methods: U.S. Small Business Administration data included all PPP recipients, which were identified as healthcare organizations by the North American Industry Classification System (NAICS). Metro status was determined by the Rural-Urban Continuum Code associated with each organization’s zip code. Outcomes included loans and jobs retained per 100,000 population.
  • Results: Non-metro healthcare organizations received fewer loans per capita (175) than metro organizations (189). This gap was driven by loans to metro physician and dentist offices. However, among all types of healthcare organizations, the largest number of retained jobs came from loans to non-profit hospitals in non-metro regions (2,303 compared to 511).
  • Implications: Rural Americans rely on non-profit hospitals for healthcare and employment. Had non-profit hospitals been excluded from the program, as was initially expected, these hospitals may not have survived the pandemic. Future research should continue investigating program variation, but more importantly evaluate this variation on short-term outcomes during the pandemic and the long-term financial solvency of rural providers.