MAX Insights: Banding Together

Rural hospitals look to each other for long-term solutions

By Michelle A. Williams, US Lifeline Analyst

Maintaining high quality and affordable healthcare for rural communities has become a challenge for rural hospitals. Grappling with CMS reimbursement rates and finding way to cut costs has created an urgent issue across the United States. While some rural hospitals seek acquisitions by or affiliations with larger healthcare systems to improve their odds of survival, some are choosing a different path and embracing long-term solutions through regional collaboration.

According to the National Rural Health Association (NRHA), rural hospitals have closed since 2010, with seven just this year. ⁷ Sixty-two million patients count on rural healthcare and, with 283 rural hospitals on the verge of closing their doors, action is vital.⁶ NRHA’s VP of government affairs, Maggie Elehwany, spoke at the Rural Health 101 briefing hosted by the US Senate Rural Health Caucus demonstrating that the crisis is in need of immediate federal intervention.⁵ While legislatures continue to debate and plan, two groups of rural hospitals, one in Arizona and one in New Hampshire, have taken proactive steps to increase their odds of survival in the unsettled healthcare environment.

 Collaborative designs
Southern Arizona Hospital Alliance², funded by founding member Tucson Medical Center (TMC) (Tucson, Ariz.), includes Copper Queen Community Hospital (Bisbee, Ariz.), Mount Graham Regional Medical Center (Safford, Ariz.), Benson Hospital (Benson, Ariz.), and Northern Cochise Community Hospital (Willcox, Ariz.). Each hospital will remain independent and locally governed. However, they will share purchasing, grant writing services, insurance, electronic medical records, resources, and coordinated clinical care.

Through collaboration with the Mayo Clinic Care Network (Rochester, Minn.) TMC opens the door for alliance members to access specialists through a consultation network.⁴ Along with access to specialized patient care, the group aims to improve operating efficiencies, transfer patients between facilities, and reduce costs through bulk purchasing, staff training, and physician recruitment.²

Rural hospitals in New Hampshire’s remote North Country took a different route and, after two years of negotiations, signed a formal affiliation agreement in June 2015 establishing North Country Healthcare³. The non-profit healthcare system includes Androscoggin Valley Hospital (Berlin, NH), Littleton Regional Healthcare (Littleton, NH), Upper Connecticut Valley Hospital (Colebrook, NH), and Weeks Medical Center (Lancaster, NH).

The four hospitals will continue to receive individual community oversight by their local board of trustees; however, North Country Healthcare’s new board and management will institute overall strategy and direction.³ Goals of the coordinated network include quality improvements, increased efficiencies, and lower healthcare costs for the region’s residents. The affiliation agreement will be reviewed by NH Attorney General’s Charitable Trust Division and, once approved, North Country Healthcare is expected to be in operation in 2016.

Advocacy groups and hospital leaders continue to fight to keep rural healthcare accessible and affordable for communities.¹ Healthcare industry leaders and analysts will be watching the two collaborative designs, Southern Arizona Hospital Alliance and North Country Healthcare, to examine what effect each has on the financial health and stability of the hospitals involved. If successful, rural hospitals will be more inclined to work together to secure positions in meeting the needs of the rural community.

Notes

¹ http://news.aha.org/article/hospital-leaders-urge-congress-to-support-unique-needs-of-rural-patients-

² http://tucson.com/news/science/health-med-fit/tmc-rural-hospitals-form-partnership-to-fight-closures/article_400396d0-d148-599c-a1d7-03d4de9cf581.html

³ http://www.northcountryhealth.org/news/important-affiliation-milestone-achieved

http://www.willcoxrangenews.com/news/article_1c833ff0-1467-11e5-b1c9-8f4eccc354db.html

http://blog.ruralhealthweb.org/2015/06/nrha-speaks-at-rural-health-101-for-senators/

http://www.ruralhealthweb.org/go/left/government-affairs/congressional-action-kit

http://www.shepscenter.unc.edu/programs-projects/rural-health/rural-hospital-closures/

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