by
Lisa Chamoff, Contributing Reporter | December 21, 2016
From the December 2016 issue of HealthCare Business News magazine
Tim Putnam, president of Margaret Mary Health, a not-for-profit critical access hospital in Batesville, Indiana, located an hour from both Cincinnati and Indianapolis, agrees. “The move from volume to value is something we initially saw as quite a challenge,” Putnam says. “But small community hospitals like ours are well positioned to be successful in that model.” Unlike urban facilities, which face steep competition and can have a tough time reaching out to people in densely populated communities, rural hospitals can help boost healthy living at social organizations and religious institutions, a practice that is becoming more common.
“When I go into churches or other social organizations here, all of the people in these groups are served by my hospital,” Putnam says. “I can invest in a congregational health improvement plan knowing that our entire investment will improve the health of patients directly served by my hospital.” Margaret Mary Health also has staffing challenges, but has successfully recruited people who have grown up in the area to work at the hospital, including many health care professionals who have come through mentorship programs the hospital coordinates with local high schools.
“To build that pipeline takes a long time and a lot of effort, but we’ve already had a number of successes,” Putnam says. Barnett, of McKenzie Health System, advises other hospital leaders to look “for partners that are truly interested in your success and developing a culture that is comfortable with the changes that we need to be making today. Transitioning the delivery of care to wellness and value is not easy and often conflicts with how we are paid, but it is where we need to go.”
Similar, but different, in cities
Urban hospitals are also facing a number of challenges, due to the low-income populations they serve and a barrage of government cuts. Changes to the formula for distributing DSH payments, enacted under the Affordable Care Act, have a big impact on urban facilities, which serve a high percentage of patients living below the poverty line, and they still face uncompensated care and payment reductions for hospital readmissions that don’t account for a patient’s socioeconomic status, and compare hospitals without similar patient populations, says Ellen Kugler, executive director of the National Association of Urban Hospitals. “Operation is challenging as payment systems are evolving and changing,” Kugler says. In Michigan, the Henry Ford Health System has had success collaborating with a network of skilled nursing facilities to reduce hospital readmissions.
