Instead of Selling, Some Rural Hospitals Band Together To Survive
Bowman, ND-Retta Jacobi is mounted on a metal platform which raised it to an entrance on the side of a custom-designed semi-trailer. Once inside, she lying on a platform that technicians have slipped into an MRI machine. Jacobi hoped that the scan would help identify the source of pain in his shoulders.
The MRI mobile unit visits Southwest health services, Bowman hospital, North Dakota every Wednesday. Without this, the 1,400 residents of the community should drive 40 minutes to get to an MRI machine, expensive medical equipment that the hospital could not afford alone.
Southwest Healthcare Services and 21 other independent and rural hospitals in Northern Dakota are part of the Rough Rider network, which has used rollers of patients combined with its members to negotiate better prices for the mobile imaging truck.
Independent rural hospitals are increasingly joining what are called clinically integrated networks, collaborative groups that allow them to avoid selling to larger health systems while sharing resources to save money and improve patient care. Many are motivated by the possibility of combining their patient rolls for value -based care contracts, a growing reimbursement model in which insurers pay suppliers according to the quality of the care they provide and the health results of their patients.
Networks supporters explore whether the funding of the rural health processing program of $ 50 billion – which is part of President Donald Trump’s recent tax on tax and expenses – can be used to help or extend these organizations.
For independent rural hospitals, networks are an alternative to the closure or reduction of services, or to the abandonment of local autonomy and the support of a large hospital system.
“Anything that can help our rural hospitals and adding services is great,” said Jacobi, who offers children in the local school district.
Since 2010, 153 rural hospitals in the United States have completely closed or have ceased to offer services to hospital patients, according to the Sheps Center for Health Services Research at the University of North Carolina. A much larger number, 441, merged with or was acquired by hospital systems between 2011 and 2021. It is according to a report commissioned by the coalition to strengthen American health care, a group for the defense of hospitals and health associations.
The Rough Rider network provides a leveraging effect to its members, which serve approximately two thirds of rural dakotans in the North, said Dennis Goebel, CEO of Bowman Hospital.
Health care sellers “would probably not speak to us if we are ourselves,” he said. “They don’t look for small and tiny crumbs. They want a big contract, and they will give you better prices. ”
Some rural networks share specialists who do not need full -time in a single hospital, according to Commonwealth Fund, a non -profit organization focused on improving the health care system. Some networks also invest in broadband, housing and other community development projects that can help people stay healthy and access care.
Hospitals can pool staff members for a network health insurance scheme on a network level, said Nathan White, CEO of Cibolo Health, a company that helps launch and manage networks in rural areas. He said they could also conclude shared contracts for remote charts, prescription medication programs and other services.
White said he launched Cibolo Health after a leader in an independent hospital in Rural Dakota asked him to collaborate with similar facilities. The Rough Rider Network was launched at the end of 2023 with the help of the company and $ 3.5 million in the Northern Dakota Legislative Assembly.
Since then, Cibolo Health has helped start networks in Minnesota, Nebraska, Montana and Ohio. Once the sixth opens in September, the networks affiliated with Cibolo will represent more than 120 hospitals, with service zones covering 4.7 million people, said White.
Networks, which are non -profit from hospitals, pay annual costs in Cibolo Health, a for -profit business, for management services. White said that managers of 10 other states plan to join this model.
Similar networks have existed for more than 30 years, but have become more popular after the adoption of the 2010 affordable care law, according to a Rand Corp. A non -profit research organization.
Rural health care providers are increasingly interested in training such networks, said Marnell Bradfield, executive director of the Community Care Alliance, a network of independent primary care offices which was launched in 2015 in Rural Western Colorado. About once a month, she said, she receives a call from health care leaders exploring similar networks and asking questions about her experience.
The Rand Corp. wrote in his 2020 article that he had found no academic study that examined whether these networks do what his supporters claim – save money and improve patient care.
“In theory, quality should improve with the alignment of health care organizations, but there is no evidence,” said the report. The document also said that these networks could eventually increase prices, which can occur with traditional mergers and acquisitions.
Bradfield and White said they had the evidence, at least for their organizations.
The members of the Community Care Alliance have reduced their insurance costs while improving the results of patients, such as reducing their need for hospital care and emergency, said Bradfield.
White said that data from a pilot program between Caret Health, a care coordination company and SMP Health-St. Kateri, one of Rough Rider’s hospitals, has shown that the program has helped a large number of patients catch up with preventive care.
Gabby Wilkie, director of finance at St. Kateri Hospital in Rolla near the Canadian border, said that Cares health personnel called and sent a text to patients who were late on annual physical exams, cancer screening, vaccinations and other visits. She said that staff have explained to patients why this preventive care is important for their health before making a call to three with St. Kateri staff to make an appointment. White said it took an average of 11 awareness attempts before patients come for any visit.
“To be honest, we didn’t have the resources to reach out,” said Wilkie.
She said St. Kateri would have spent about $ 300,000 to make this type of awareness for 1,000 patients. Meanwhile, she said, the hospital estimates that it will earn more than $ 100,000 when many patients come for their preventive care. Cibolo Health and The Rough Rider Network both contribute to the cost of the Health Service Caret, which now takes place in other network hospitals.
Goebel said that joining a network to remain independent is also beneficial for the economy of rural areas, where hospitals are often major employers. He said that health systems sometimes reduce the services and staff of the rural hospitals they acquire.
Jacobi takes medication and does physiotherapy after a doctor examined his MRI results. If this does not work, she may need to go back and forth in Bismarck to get a steroid shot guided by ultrasound. Jacobi was grateful that she could get a diagnosis and processing advice without having to travel far for MRI.
“Whenever we can maintain more local control, it’s a good thing for our small cities,” she said.
