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HELP WHERE HOSPITALS NEED IT ®

Community Hospital Blog

Affordable Care Act
Beating the Odds in Rural Healthcare

By Wilson Weber, Executive VP and COO, CHC

 

Rural hospitals operate as a healthcare safety net for smaller

communities, where demographics tell the story about these community-based hospitals. Patients tend to be older than those at urban or suburban hospitals, many patients are uninsured, and rural facilities have to maintain emergency rooms and beds for acute care even if they see fewer patients. In the last five years, Congress has sharply reduced spending on Medicare, and this decline in reimbursement rates has been particularly challenging for rural hospitals.

 

Along with the need for hospitals and healthcare services, our rural hospitals need more primary care physicians (PCPs) to care for patients. According to data from the Agency for Healthcare Research and Quality, there are 68 PCPs per 100,000 people in rural areas, compared with 84 per 100,000 in urban areas. Approximately 65 percent of primary care health professional shortage areas are in rural counties, according to Rural Healthy People 2020. This lopsided geographic distribution makes it doubly difficult for rural hospitals to maintain the health of their communities.

 

Like any business, a hospital’s financial well-being is tied to expenses and revenue. The tried-and-true formula is to increase revenue and reduce costs. That’s simple enough — yet bottom-line results for a rural hospital mean more than just the numbers. Employees, patients and the surrounding community depend on the hospital’s continued success.

 

In spite of the challenges, some community hospitals are seeing better financial performance. Let’s examine some actions they are taking to improve the bottom line.  

  1. Identify areas needing improvement. Begin by looking at the basics. For example, Yoakum Community Hospital in Yoakum, Texas began working to qualify the payer status of patients prior to admission. Self-pay patients may qualify for Medicaid or another reimbursement source. This step alone can make a significant difference in increasing revenue. 
  2. Strengthen physician relations. Great Plains Regional Medical Center includes physicians in leadership positions to enhance relationships between hospital executives and physicians. Currently physicians account for roughly one-third of the hospital's board, so they have a voice in the hospital’s strategic decisions. Hospital-physician collaboration can improve quality and cost efficiency. And because a significant part of the growth and success of a hospital is dependent upon the right mix of physicians and specialists, creating or revising your medical staff development plan should also be on your “to-do” list. 
  3. Benchmark performance against similar hospitals. Compare clinical data. This is a great way to identify opportunities for improvement and potential cost saving, and facilitate movement toward value-based care.
  4. Think about partnerships. If internal improvements aren’t sufficient, community hospitals may want to consider forming relationships with other organizations. Analyze the advantages and disadvantages of a potential partnership. What is the community hospital expected to provide? What amount of control they will cede for the expected benefits of the partnership? Make sure cultures are aligned and define expectations at the start.
  5. Ensure board involvement. Your board can be your biggest advocate and ally. When board members are better educated about their responsibilities, including overseeing finances, clinical quality and strategy, their support and ideas can be invaluable.

Financial stability is the solution to beating the odds in rural healthcare. Find out more about how CHC is helping hospitals.

 

Tags: Affordable Care Act, Hospital Performance Improvement, Operational Improvement, Partnership, Strategic Direction
CHC Prescription for Board Competency Featured in HealthLeaders Magazine

At a time when hospitals are under extreme pressure, only 66 percent of CEOs consider their boards strong or very strong and 11 percent consider them weak or very weak, as published in HealthLeaders Media Industry Survey 2013. Many boards simply aren’t up to speed on all the forces at work in the current healthcare climate, including the Patient Protection and Affordable Care Act. Boards require education to make sense of these challenges and assess the long-term viability of their organizations.

 

CHC Consulting, the management and consulting arm of CHC, works with hospital boards on education as well as strategic vision. CEO Mike Williams shared best practices for hospital boards in the May cover story of HealthLeaders magazine, “Building Better Boards,” including:

  • A longer commitment by board members of three, three-year terms
  • A robust quality committee with multidisciplinary clinical representation
  • More active and vocal audit and compliance committees
  • Placing more accountability on the CEO
  • Engaging in advocacy efforts and dialog with elected officials  

Read the full article here.

 

Learn about CHC’s Board Advisory Services here, and call us to assist your hospital board and management with strategic decisions that affect your hospital’s future.

Tags: Affordable Care Act, Healthcare Reform , Hospital Board Advisory
Healthcare reform – challenges and action steps for community hospitals

Hospitals are expected to implement new payment and delivery models now that the Supreme Court has upheld the Patient Protection and Affordable Care Act. But community hospitals may have difficulties transforming their organizations due to limited resources and other challenges.

 

CHC’s president and CEO Mike Williams spoke this month with Becker’s Hospital Review about the challenges facing community hospitals and immediate actions to take in order to weather current and future changes in healthcare.

 

The four main challenges are:

  • Revenue cycle. As Medicare reimbursement levels decline, community hospitals may suffer most because they serve a disproportionate number of Medicare and Medicaid patients. In addition, many community hospitals lack the clout to secure the best rates from managed care providers.
  • Access to capital. In part due to reduced reimbursement, community hospitals also lack access to capital. This prevents them from updating their facilities, which can affect patient volume and quality of care.
  • Physician recruitment. There’s a nationwide physician shortage, and on top of that, it can be difficult to attract primary care physicians and specialists to remote or rural areas.
  • Hospital-physician alignment. Community hospitals, like all hospitals, struggle to work cooperatively with medical staff to improve quality and lower costs.

 Six actions can be taken immediately to address these challenges:

  • Optimize internal operations. The goal is to provide care in a cost-effective manner with the best possible outcomes.
  • Benchmark performance against similar hospitals. Comparing clinical data can help identify opportunities for improvement.
  • Assess feasibility of independence. After making as many internal improvements as possible, community hospitals must assess the feasibility of remaining independent, now and in the future.
  • Consider partnerships. If internal improvements aren’t sufficient to compete in the marketplace, community hospitals should consider forming relationships with other organizations. When seeking a partner, community hospitals should make sure the hospital’s culture aligns with the prospective partner’s culture; define expectations upfront; and make clear what they must provide in return and the amount of control they will cede for the expected benefits of the partnership.
  • Ensure board involvement. The board may need to be educated about its responsibilities, including overseeing finances, clinical quality and strategy.
  • Collaborate with physicians and involve them in the hospital’s governance.

Read the full Becker's Hospital Review article.

  

If these health reform challenges sound all too familiar, CHC can help with operations assessment, board education, strategy development and, if necessary, partnership options. Call us today at 972.943.6400.

Tags: Affordable Care Act, Healthcare Reform , Hospital Board Advisory, Hospital-Physician Alignment, Independence, Operational Assessment , Patient Protection , Physician Recruitment, Strategic Direction
ACA ruling mandates Community Health Needs Analysis. Isn’t it time you got started?

ACA ruling mandates Community Health Needs Analysis. Isn't it time you got started?

 

The Supreme Court has spoken. And though the justices may not have the last word on the Patient Protection and Affordable Care Act (politicians are still debating), their ruling means the ACA is now the law of the land and hospitals must take action to satisfy its requirements.

 

One of the new requirements states that not-for-profit, charitable hospitals must conduct a Community Health Needs Assessment (CHNA) once every three years and develop a plan to meet the health needs of the community.

 

Like many hospitals, you probably have questions about the Community Health Needs Assessment (CHNA) and Implementation Plan requirements. Perhaps you’re wondering if your facility has the staff or time to complete the assessment and implementation plan. Perhaps you aren’t sure when your specific assessment and implementation plan must be completed.

 

This is where CHC Consulting can help.

 

At CHC Consulting, we take a flexible approach in working with our clients. We can complete the entire community needs assessment from start to finish or provide assistance in certain areas such as:

  • Data collection
  • Conducting one-on-one interviews, focus groups or surveys
  • Writing the report after your facility has completed the analysis

To learn more about the CHC Consulting Community Health Needs Assessment process and how we can help you meet the new regulations, contact David Domingue at ddomingue@communityhospitalcorp.com or visit the Community Health Needs Assessment page on our Website.

Tags: Affordable Care Act, Community Health Needs Assessment, Healthcare Reform , Hospital Board Advisory
Community Health Needs Assessments - Have questions? We have answers.

The passing of federal health reform legislation – the Patient Protection and Affordable Care Act – has already brought many changes to hospitals including four new requirements for not-for-profit, charitable hospitals. One of those new requirements states that not-for-profit hospitals must conduct a Community Health Needs Assessment (CHNA) once every three years and develop a plan to meet the health needs of the community.

 

Are you one of many hospitals that has questions about the Community Health Needs Assessment (CHNA) and Implementation Plan requirements? Do you wonder if your facility has the staff or time to complete the assessment and implementation plan? Do you know when your specific assessment and implementation plan must be completed?

 

This is where CHC Consulting can help. We use the six step process listed below.

 

At CHC Consulting, we take a flexible approach in working with our clients. We can complete the entire community needs assessment from start to finish (as described above) or provide assistance in certain areas such as:

  •  Data collection
  • Conducting one-on-one interviews, focus groups or surveys
  • Writing the report after your facility has completed the analysis

To learn more about the CHC Consulting Community Health Needs Assessment process and how we can help you meet the new regulations, contact David Domingue at ddomingue@communityhospitalcorp.com or visit the Community Health Needs Assessment page on our Website.

Tags: Affordable Care Act, Community Health Needs Assessment, Healthcare Reform

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