Roundtables

So many community hospitals want to stay independent these days. We think independence is great if they can do that. But independence doesn't mean isolation. Being a partner with some- thing bigger, even just an affiliation, helps with the future sustainability of the hospital. What we advocate is that the independent hospitals can stay independent but need to be a part of the combined strength offered through health systems and organizations like CHC. Q: How could a strategic regional relationship prepare parties for health reform? Charlotte Burns: ere are not a lot of independent community hospitals today, and it's getting harder and harder for them to survive. In Tennessee, three rural hospitals have closed in the past year and a half. In today's healthcare environment, it is important for inde- pendent rural hospitals to have a tertia- ry partner. I believe one of the primary benefits of having a partner is to help them operate more efficiently which in turn helps them to remain independent and allows them to continue serving their communities. For the tertiary side, healthcare is local, so we need to connect with those outlying hospitals and primary care physicians. As we hear more about bundled payments, population health management, accountable care organi- zations, clinically integrated networks, etc., we have to be coordinated in our efforts. We also need to make sure our IT systems "talk" to each other so that appropriate information can be shared. Strategic partnerships will allow for better coordination of healthcare as we move into the future. Phyllis Cowling: Again, I think it accelerates or elevates relationships. We hear certain words when we talk about reform, like the need for strong alignment and economies of scale. e ability to increase efficiency and effec- tiveness are paramount for all of us. We have a better chance to do that together than separately. ere's no guarantee for any of us right now, but a strategic regional relationship increases the like- lihood for success. Shane Kernell: We're looking at a lot of apples to oranges comparisons. e [Patient Protection and Affordable Care Act] affects us differently than in Austin; our payer mix dictates that. e payment for ACA to get every- one covered by insurance is going to be done by cutting our largest payer source. If we don't align ourselves with a larger dance partner and strategically build new businesses in alignment with a clinical affiliate, that's going to be a problem. Cindy Matthews: We're seeing more and more that healthcare systems are joining up in one way or another. Rural hospitals don't want to be le out in the cold when hospital systems decide who to partner up with. ey should be aware that creating an afflation is an appropriate option. And for larger systems, looking around geographically and making sure they have delivery points out there even in smaller com- munities is going to help prepare them for population health management and for future contracting purposes.n "There's no guarantee for any of us right now, but a strategic regional relationship increases the likelihood for success." -Phyllis Cowling, President and CEO of United Regional Health Care System Ms. 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 healthcare 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 relationship we've crafted: It allows the commu- nity hospital to strengthen its management team while maintaining indepen- dence and local board control and oversight. Mr. Kernell: Let me share one service line in particular: our OB service line. We deliver 275 to 300 babies a year. Our community has benefitted 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 some- one 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. Ms. Matthews: Occasionally we will brand the community hospital with the larger hospital's brand. This provides a little bit of a halo for consumers and is seen as a real benefit. So many community hospitals want to stay independent these days. We think independence is great if they can do that. But independence doesn't mean isolation. Being a partner with something bigger, even just an affilia- tion, helps with the future sustainability of the hospital. What we advocate is that the independent hospitals can stay independent but need to be a part of the combined strength offered through health systems and organizations like CHC. Q: How could a strategic regional relationship prepare parties for health reform? Ms. Burns: There are not a lot of independent community hospitals today, and it's getting harder and harder for them to survive. In Tennessee, three ru- ral hospitals have closed in the past year and a half. In today's healthcare en- vironment, it is important for independent rural hospitals to have a tertiary partner. I believe one of the primary benefits of having a partner is to help them operate more efficiently which in turn helps them to remain indepen- dent and allows them to continue serving their communities. For the tertiary side, healthcare is local, so we need to connect with those out- lying hospitals and primary care physicians. As we hear more about bundled payments, population health management, accountable care organizations, clinically integrated networks, etc., we have to be coordinated in our efforts. We also need to make sure our IT systems "talk" to each other so that appro- priate information can be shared. Strategic partnerships will allow for better coordination of healthcare as we move into the future. Ms. Cowling: Again, I think it accelerates or elevates relationships. We hear certain words when we talk about reform, like the need for strong alignment and economies of scale. The ability to increase efficiency and effectiveness are paramount for all of us. We have a better chance to do that together than separately. There's no guarantee for any of us right now, but a strategic re- gional relationship increases the likelihood for success. Mr. Kernell: We're looking at a lot of apples to oranges comparisons. The [Pa- tient Protection and Affordable Care Act] affects us differently than in Austin; our payer mix dictates that. The payment for the PPACA to get everyone cov- ered by insurance is going to be done by cutting our largest payer source. If we don't align ourselves with a larger dance partner and strategically build new businesses in alignment with a clinical affiliate, that's going to be a problem. Ms. Matthews: We're seeing more and more that healthcare systems are joining up in one way or anther. Rural hospitals don't want to be left out in the cold when hospital systems decide who to partner up with. They should be aware that creating an afflation is an appropriate option. And for larger systems, looking around geographically and making sure they have delivery points out there even in smaller communities is going to help prepare them for population health management and for future contracting purposes. n Community Hospital Corporation owns, manages and consults with hospitals through three distinct organizations – CHC Hospitals, CHC Consulting and CHC ContinueCARE, which share a common purpose to guide, support and enhance the mission of community hospitals and healthcare providers. Need Some Direction? When hospitals need guidance, they turn to Community Hospital Corporation. For nearly two decades, CHC has kept hometown hospitals on track, offering operational and financial improvement, strategic visioning, and help with regulatory compliance. Depending on your hospital's needs, a short-term consulting engagement may point you in the right direction, or CHC can accompany you all the way with ongoing management support and ownership models. Call CHC today to move forward with confidence and in the right direction. Community Hospital Corporation owns, manages and consults with hospitals through three distinct organizations – CHC Hospitals, CHC Consulting and CHC ContinueCARE, which share a common purpose to guide, support and enhance the mission of community hospitals and healthcare providers. 972.943.6400 | CommunityHospitalCorp.com HELP WHERE HOSPITALS NEED IT. ® BeckersDirection.indd 1 7/28/14 1:31 PM "There's no guarantee for any of us right now, but a strategic regional relationship increases the likelihood for success." — Phyllis Cowling, President and CEO of United Regional Health Care System 5 Community Hospital Affiliation Strategies

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