Becker's Hospital Review

Focus On Community Hospitals 25 Community Hospital Roundtable: 3 Leaders Weigh-In on Challenges, Opportunities By Anuja Vaidya C ommunity hospitals occupy an important and unique place in the healthcare industry. They are in a position to provide quality care to patients close to home and often develop lasting bonds with the communities they serve. Not only do they take care of the health needs of their communities, but they also provide employment opportunities for them. Here, leaders from reputed community hospitals discuss the unique benefits and challenges of serving a specific population, and also discuss initiatives that their organizations are planning to implement in the near future. Question: What are some of the benefits of being a community hospital? Robert Lord, Senior Vice President for System Facility Management, Chief Legal Officer and Tradition Medical Center Campus Leader, Martin Health System (Stuart, Fla.): Martin Health System is missiondriven, with its sole focus on serving the needs of the community in which we live. Our organization has always maintained extremely close relationships with local civic and business leaders, governmental agencies and charitable organizations. Through communication and collaboration we work closely with our constituencies to meet their needs. The only reason Martin Health System exists is to provide exceptional healthcare services to our families, friends and neighbors. In return, we receive great support from our community. David Cheney, CEO, Banner Boswell Medical Center (Sun City, Ariz.): Our greatest benefit as a community hospital is that we focus our care on a specific population — the elderly. This allows us to become experts in that care. This year, Banner Boswell was recognized for the second year in a row as one of the nation's 100 Top Hospitals by Truven Health Analytics, in large part because of our expertise in the delivery of care to our surrounding community. Another benefit of being a community hospital is that we have a close relationship to our community members. This relationship provides the hospital with access to an active volunteer group. Patients can remain close to their homes, families and friends. As a community hospital, we also have a more direct relationship with other providers along the continuum of care, for example, skilled nursing facilities, hospice, home care and assisted living. John Fitzgerald, CEO, Inova Fair Oaks Hospital (Fairfax, Va.): Being a community hospital gives us an opportunity to be focused on delivering care to the community. For the most part, community hospitals are about delivering care to the community as opposed to large research centers or academic centers. It is a very personal one-on-one relationship with the community. We really like that personal relationship we have. They know you and you know them. Together, we work to ensure the health and vitality of our friends and neighbors. David Cheney Q. What are some of the challenges of being a community hospital and serving a specific population? Mr. Lord: Martin Health System serves one of the nation's most Medicare-dependent service areas. We also provide a significant amount of care to Medicaid beneficiaries, as well as providing substantial charity care. We are not a part of a hospital taxing district, limiting local tax support. Recent reductions in reimbursement from Medicare or Medicaid will challenge our ability to meet the future needs of our community and the anticipated requirement of new payment methodologies. It is also a challenge to compete with the large hospital chains when it comes to the costs of supplies, purchased services and large capital expenditures. Mr. Cheney: Banner Boswell is a community hospital in a predominantly Medicare environment. This makes it challenging to attract and retain both primary care providers and specialists. As a community hospital, we have limited access to subspecialists. Also, most physicians do not reside in the community and therefore are reluctant to commute to the hospital in the middle of the night. This creates the challenge of having an adequate on-call schedule for our emergency department. The fact that we serve a specific population — elderly — presents another challenge for Banner Boswell. Elderly individuals have chronic conditions and tend to be complex patients. In addition, these patients require coordination of care, which can also be a challenge. The population we serve also experiences their own challenges. For example, elderly individuals have limited access to transportation for follow-up care, pharmaceuticals, etc. Q. What are your organization's strategies for overcoming those challenges? Mr. Lord: One of the key initiatives for Martin Health System in recent years has been our implementation of Lean management tools through our performance excellence program, John Fitzgerald Rob Lord

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