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Community Hospital Blog

Strategic Direction
What does it take for community hospitals to remain independent?

In today’s healthcare industry, more and more hospitals are exploring various types of affiliations, ranging from governance and ownership transfers to business management contracts and clinical partnerships. While collaboration and consolidation are on the rise, plenty of hospitals remain independent. These standalone hospitals often share certain characteristics.


In an Oct. 31 article for Becker’s Hospital Review, CHC’s President and CEO Mike Williams discusses factors correlating with independence: size and demographics of the community; payer mix; strong finances (i.e., accumulated cash); and strong clinical relationships with physicians and institutions.


Williams also weighs in on a tough question: In today’s healthcare industry, is independence something hospitals should strive for? “Every hospital is unique,” he says, offering hospitals some considerations to evaluate:

  • How has the hospital been managed in the past?
  • What are its financial ratios?
  • Does it have a “war chest” of money to depend on as things get more financially challenging?
  • Has it sought outside consultative opinions to evaluate its cost structure and operational efficiency?
  • Have the physicians networked with peers around the country to make sure they understand how the hospital’s outcomes compare to other similarly positioned institutions?

A hospital can stay independent with sufficient motivation and finances, and if that’s the best way to serve the community, the article concludes.


Read the full Becker’s article: “To Be or Not To Be Independent: 5 Considerations for Community Hospitals.”

Tags: Hospital Board Advisory, Independence, Operational Assessment , Strategic Direction
Expert Panel: It’s Decision Time for Community Hospitals

The road ahead for community hospitals was the topic of a recent roundtable discussion involving CHC's president and CEO Mike Williams, along with three community hospital CEOs, and facilitated by editors of Health Leaders magazine. Highlights from their discussion are featured in the article "Decision Time for Community Hospitals" in the October issue of HealthLeaders.


For his part, Williams says hospitals must proactively and realistically assess "their own viability to be independent in the future." He advocates a close working relationship between the hospital CEO and its board for addressing issues and facing challenges that lie ahead.


In summary, the path of success for community hospitals depends on:

  • Taking a responsible view rather than getting to a point of reaction 
  • Understanding your competition and finding your niche among them
  • Controlling costs while still offering quality services
  • Attracting and retaining physicians

 Read the full article.

Tags: Hospital Board Advisory, Hospital Management, Independence, Operational Assessment , Partnership, Strategic Direction
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
Great Plains Regional Medical Center Contracts with CHC Consulting

On April 1, 2010, Great Plains Regional Medical Center (GPRMC) of North Platte, Nebraska, signed a contract with CHC Consulting to provide strategic advisory and consulting services. The medical center selected CHC Consulting as part of an extensive RFP process. CHC Consulting is the management and consulting arm of Community Hospital Corporation (CHC).


The GPRMC Board selected CHC Consulting to serve as an industry expert and Board advisor and to deliver specific consulting services to the medical center leadership team, including:

  • Strategic positioning
  • Operational support
  • Management tools and best practices
  • Recommendations for organizational improvements
  • Collaborative accountability between CHC Consulting, the Board, medical center leadership, and the medical staff

"We are delighted to have the opportunity to work with Great Plains Regional Medical Center. GPRMC has done a great job of providing quality care to the many communities it serves, and we are delighted to provide additional resources to help the team meet its vision," says Mike Williams, CHC CEO.


Great Plains Regional Medical Center is a 116-bed hospital serving patients from Lincoln County, Nebraska and the surrounding area through a variety of healthcare services and programs.


CHC is a Texas not-for-profit company whose sole mission is to help not-for-profit hospitals remain community-operated and governed. Through ownership, management services or consulting, CHC provides the resources and experience community hospitals need to improve quality outcomes, patient satisfaction and financial performance. For more information about CHC, please visit the website at www.communityhospitalcorp.com.

Tags: Hospital Board Advisory, Hospital Management, Operational Improvement, Strategic Direction

CHC in the Spotlight