Case Study

Guidehouse Supports Health Systems and Local Government Entities’ Allocation of $10B in Federal COVID-19 Aid

Providers, government agencies leveraging deep healthcare strategy, federal disaster funding, and policy expertise in efforts to obtain and substantiate federal funding use.

Guidehouse has helped:

  • More than 20 state and local government entities obtain and substantiate $7B in CRF and FEMA funding.
  • More than 350 providers obtain and substantiate $3B in FEMA and CARES Act funding. 


Pandemic Impact

Health systems and state and local government entities continue to endure unprecedented challenges in obtaining the resources needed to care for their communities during the COVID-19 pandemic. To help providers and government agencies manage through the prolonged pandemic, the federal government has made available several funding streams to reimburse hospitals for their evolving pandemic-related costs and revenue loss, as well as provide critical funding to state and local government entities for their COVID-19 needs.

The first Provider Relief Fund (PRF) and Coronavirus Relief Funds (CRF) were followed by an evolving stream of federal guidance touching every aspect of funding access, use, and reporting. Frequent and sometimes daily changes in federal guidance from agencies with overlapping interests made the complex regulatory environment even more challenging.

Given the multitude of funding, the coordination of benefits across all relief sources is critical in identifying applicable funding sources based on eligibility criteria, avoiding duplication of benefits, and tracking application status, receipt of funds, and days to repayment. Both the Department of Health and Human Services (HHS) and Treasury require their respective relief fund recipients to fully comply with all the terms and conditions of their specific allocation of funds or face recoupment of some or all payments.

All relief fund recipients are subject to review and audit by the federal Office of Inspector General (OIG) to verify compliance with the various terms and conditions. In addition to this OIG review, the funding is subject to the single-audit requirements of the federal Uniform Guidance.



Uniquely qualified to help providers and government agencies understand and apply evolving guidance, Guidehouse provides advisory support as providers and agencies seek to obtain, substantiate, and report federal COVID-19 aid. As current and future COVID-19 aid is distributed to hospitals and governments, funding and reporting coordination—tracking and documenting funds distribution across all grants, loans, and other sources—is essential. 

Guidehouse is working with organizations across several areas, including:


  • Appropriately documenting expenses and lost revenues associated with COVID-19.
  • Applying for reimbursement for eligible costs through the FEMA Public Assistance program.
  • Managing financial, operational, and government relations efforts, including applying for specific program opportunities, and supporting efforts to educate policymakers.
  • Assisting with Coronavirus Aid, Relief, and Economic Security (CARES) Act PRF reporting and documentation compliance, including advising on conditions required to receive aid, preparing for a potential independent audit, and understanding compliance.
  • Identifying, prioritizing, and implementing initiatives to ensure organizations’ enterprise operating model can prevent, prepare for, and respond to COVID-19 surges with available federal aid. Areas of focus include facility retrofitting and expansion, IT and digital (electronic health records, telehealth, and teleworking), revenue cycle, care management, and supply chain projects. 

 State & Local Government Entities

  • Designing COVID-19 grant strategy, including allocation of CARES Act funds for various programs and coordination of benefits with overlapping eligibility of various grants within the CARES Act and the Consolidated Appropriations Act.
  • Developing a portfolio of projects/programs incorporating multiple grants to address such needs as small business disruption assistance, rental assistance, direct assistance, education grants, and more.
  • Establishing a project management office and provide oversight and administration of grants through the life cycle, including vendor management.
  • Initiating an integrity monitoring program that includes eligibility verification, compliance monitoring, and closeout.



To date, Guidehouse has helped 350 hospitals and health systems and more than 20 state and local government entities obtain and substantiate more than $10 billion in federal COVID-19 aid:

  • State and local government: $7 billion in CRF and FEMA funding
  • Hospitals and health systems: $3 billion in FEMA and CARES Act funding

Guidehouse continues to work with FEMA, the Centers for Medicare & Medicaid Services, HHS, state emergency management leaders, governors, legislators, and more to help shape interpretations and responses, and best position clients for success. This includes assisting with policy research aimed at enabling states and providers to develop a more precise and stable response to future disasters that impact the healthcare delivery network.

Further, Guidehouse is helping organizations better understand funding opportunities as the Biden administration implements its COVID-19 economic response legislation, the $1.9 trillion American Rescue Plan. The legislation, which was passed by Congress and signed by the President in March 2021, provides $350 billion in new aid to states and localities, $8.5 billion in new PRF funding for rural hospitals, and more than $70 billion for vaccines, testing, contact tracing, and mitigation efforts, among other measures.

Learn more about how we’re helping organizations thrive during the pandemic and beyond.

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