Issue link: https://beckershealthcare.uberflip.com/i/1492995
18 THOUGHT LEADERSHIP of the geography of New York State, so rural healthcare is key for us. We have a rural medicine training program for physicians and they need special tools. Rural healthcare is best served through use of advanced computing and communications technology, autonomous machines like drones and robots for supply logistics and other operations. We now have established an autonomous machines division and a mobile medical unit. We have a hospital at home program and an influenza-like illness program that both use body-worn sensors on remotely located patients for vital signs and other parameters. is is all part of the distribution of healthcare services beyond bricks and mortar healthcare facilities. Mark McPherson. President and CEO of Trinity Health At Home (Livonia, Mich.): Enact legislation to pay for telehealth in a home health nursing environment. During the pandemic, telehealth was shown to be highly effective as a way to provide care. It's reimbursable for physicians, but not for nursing care. Reimbursing telehealth in- home care would allow home care agencies to leverage already scarce nursing resources across an unlimited geography, mitigating many of the logistical issues of providing home care in a rural environment. Charles A. Powell, MD. CEO of Mount Sinai-National Jewish Health Respiratory Institute; Medical Director of Mount Sinai Hospital Respiratory Care Services (New York City): In the respiratory disease space, a key point of emphasis on providing access to specialty services in remote or rural regions. We are able to address potential gaps in access by leveraging technology to connect rural clinics and to connect with patients at home. For example, multidisciplinary tumor boards and multidisciplinary interstitial lung disease management programs can provide access to clinicians in practice locations that are distant from the tertiary facility hosting the discussion. We have deployed remote patient monitoring solutions to patients and home sleep study patients by direct shipping that allow us to connect with COPD patients across the continuum of care and to diagnose patients with symptoms of obstructive sleep apnea. Helen Johnson. CEO of Sparrow Eaton Hospital (Charlotte, Mich.): e expansion of broadband internet services has helped level the playing field for rural communities. While not yet complete, in those areas where access to high-speed internet is available, those communities are leveraging this basic utility for healthcare, education and economic development. Donald Lloyd, II. President and CEO of St. Claire Healthcare (Morehead, Ky.): In my view, we cannot perpetuate a stable rural health infrastructure until we address three significant issues critical to achieve rural health sustainability. First, we must develop and attract a rural-centric pipeline of talent to meet our clinical and workforce needs. Second, we must realize that it is not economically possible to sustain a full service acute care hospital in every rural community. Such a realization takes great political courage but also clinical creativity to meet the community's needs. ird, CMS and state Medicaid agencies must establish payment methodologies that sustain institutions in low volume and safety-net environments Mark Gridley. President and CEO of FHN Memorial Hospital (Freeport, Ill.): My thought is a deep focus by federal and state legislators that are truly seeking to understand the barriers to healthcare in rural communities. Many of these barriers are driven by inadequate reimbursement methodologies for noncritical access providers, which creates difficulty in staffing and, ultimately, in providing access to care that is sustainable, consistent and close to small communities. is would include innovative technological program funding in addition to stabilizing declining reimbursement amidst increasing costs. Michael Canady, MD. CEO of Holzer Health System (Gallipolis, Ohio): e solution to saving rural healthcare lies in solving the payer mix issue. Rural HCOs have such a high percentage of Medicare/ Medicaid/self-pay that it is becoming a challenging revenue issue. Closely related to this is the 20 percent initial denial rate across the board. Fix these two problems and rural healthcare can survive. omas Siemers. CEO of Wilbarger General Hospital (Vernon, Texas): Collaboration and diversification are the key strategies for future success. We should look for ways we can collaborate with other organizations and providers to expand and diversify our services. Rural hospitals will have to try new strategies, start new services, adapt to the changing needs of patients. e key is to keep our patients local so they don't have to travel for care. Rural hospitals will have to share revenue and/or pay for the services provided by other organizations/ providers. But it's worth it. We've got to grow. Jeremiah Hodshire. President and CEO of Hillsdale (Mich.) Hospital Administration: Ultimately, rural healthcare suffers from the reality that we are oen paid less than what it costs us to provide patient care. No other business or industry would be expected to survive under those conditions, and rural hospitals shouldn't have to scramble to find other revenue sources like grants, cash- only services, etc., in order to be financially sustainable. Achieving health equity for rural Americans requires us to sustain rural hospitals so we can continue innovating, investing in technology, pioneering access to care initiatives and more. Payment reform is not just the best way to save rural healthcare long-term — it is the ONLY way. Kenneth Rose. President and CEO of Texas Health Hospital Mansfield: e plight of rural healthcare in our country is one that will not be solved by hospitals and healthcare systems alone. Rural communities would be benefited by the collaboration of community services offered by other not-for-profit organizations along with hospitals. e issues in rural communities many times are more than just acute care related and have other social/societal components, which calls for more than the expertise of community hospitals. An issue as large as this brings the old saying to mind: many hands make light work. Christopher Bjornberg, CEO of Mayers Memorial Healthcare District (Fall River Mills, Calif.): e best way to save rural healthcare is to treat it as rural healthcare. Urban health is not the same as rural health but it is mostly treated the same way. Currently, Medicare is the only payer that has a program specific for rural health that takes a critical access hospital designation while Medicaid and commercial payers like Blue Cross, UnitedHealthcare and the like generally do not. Coupled with the poor reimbursement rates, are the rising administrative costs for providing healthcare. According to an article from CNN in February 2022, "Administrative costs alone make up more than a quarter of U.S. healthcare spending." If we want to save rural healthcare we have to change the reimbursement across all payers not just one and then ease the administrative burdens that go along with that. Just like it shouldn't be difficult for people to obtain good quality healthcare, it should not be difficult to get paid to provide good quality healthcare. CFO and Strategic Leaders Marty Hutson. CFO of St. Mary's Health Care System (Bayside, N.Y.): e first step to 'save' rural healthcare is to accept that the one-size-fits-none model of Medicare does not work. Rural hospitals face more difficulty in recruiting and retaining staff. Given your location, access to goods and services is also more expensive. CAH based on bed size is not effective when some facilities are too big