Executive Roundtable: Community Hospital Affiliation Strategies

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Q: Why would a larger hospital sys- tem or tertiary hospital be interested in a regional strategy? What value do they see? Charlotte Burns: Value is an import- ant word. We need to bring value to those outlying hospitals since a lot of our patients come from the areas they serve. Healthcare is local, and especial- ly in Tennessee, many people live in rural communities. We want the rural hospitals to provide the best care they can, but when their patients require a higher level of care, we would like to provide that support for those patients. Phyllis Cowling: For us, it's simply a part of who we are. Our passion is to provide excellence in healthcare for the communities we serve, where "communities" is purposely plural. As a regional referral center, we have a responsibility for multiple communi- ties within our region. at's first and foremost why we do this. Secondly, it's consistent with our stra- tegic plan. It's an opportunity to align more significantly with our secondary service area hospitals and physicians. It's a way to hopefully see benefit for both the small community as well as our organization while taking limited financial risk in doing so. Shane Kernell: I know a lot of larg- er hospitals are doing this across the board instead of buying community hospitals or trying to put them out of business. at's not practical from their standpoint. ey need us [smaller hospitals]. Bed capacity becomes an issue. Why not, as a larger hospital, align yourself with good rural hospi- tals that are geographically essential in their area and have the patient stay there? For bed capacity issues alone, that makes perfect sense. Cindy Matthews: e partners we have want the community hospital to survive. ey know consumers would prefer to have their healthcare be local. e best tertiary partners want to keep the patients in the community and be served in the community by smaller hospitals. en, for those patients that really do need a higher level of care, they can receive those services at the tertiary hospital. It's not feasible for all patients to go to the tertiary hospital if a smaller hospital closes. e best partner wants those rural hospitals to remain vital to their community and have the higher level of services come to them. Q: What are the benefits to the com- munity hospital or other players? Charlotte Burns: We help elevate the care at community hospitals through education and training, the sharing of protocols, telemedicine services, physician recruitment, assistance in becoming primary stroke centers or accredited chest pain centers, or other similar types of services. Depending on the type of relationship established, an affiliation can also assist the com- munity hospitals in operating more efficiently by providing access to a group purchasing organization to im- prove supply chain management or by offering assistance with other shared services. Phyllis Cowling: We're hopeful that it increases the likelihood of viable sus- tained healthcare services within that community. I think, as we all know, there are a lot of challenges in health- care right now, and they can be ampli- fied in small rural hospitals. Hopefully this is an avenue to ensure continued delivery of local healthcare services for those communities. Specific positives about the rela- tionship we've craed: It allows the community hospital to strengthen its management team while maintaining independence and local board control and oversight. Shane Kernell: Let me share one ser- vice line in particular: our OB service line. We deliver 275 to 300 babies a year. Our community has benefit- ted from our ability to maintain this service. St. David's has helped with best practices, policies and procedures. For example, if we have to transfer a baby or mother from St. Mark's to St. David's, our policies are so in line that when St. David's comes here to pick up, it is absolutely seamless for the patients. It works like clockwork being clinically affiliated. Further, with teleneurology, our goal is to be a regional stroke center. If someone in our area is having health issues or potentially having a stroke, they can confidently come here and get immediate attention, the same care as what they would receive if they went to St. David's, stabilize and get them off to a higher level of care. It's a huge benefit to the community. Cindy Matthews: Occasionally we will brand the community hospital with the larger hospital's brand. is provides a little bit of a halo for consumers and is seen as a real benefit. "The best tertiary partners want to keep the patients in the community and be served in the community by smaller hospitals." -Cindy Matthews, Executive Vice President of Community Hospital Corp. 4 Community Hospital Affiliation Strategies

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