5 Steps to Conserve and Sustain Rural Healthcare-Part 2

The first part of this series on overcoming some of the challenges that arise in rural healthcare addresses the current landscape and the unique pressures felt by rural facilities that have accelerated closure rates.

Before getting too far into the five-step plan to take action in conserving and sustaining rural healthcare, here are a few things policymakers are doing to push through legislation in support of rural health.

Policy Solutions: National Efforts to Protect Rural Hospitals

In the past year policymakers have begun to introduce legislation to address some of the challenges facing rural hospitals and help protect these critical community centers. With much needed advocacy from national organizations like National Rural Healthcare Association (NRHA) and American Hospital Association (AHA), healthcare legislation designed to address issues hampering rural providers speak to progress. Bills such as “The Save Rural Hospitals Act” and “The Rural Hospital Regulatory Relief Act”, work to level the playing field for rural hospitals.

Continued advocacy from the top levels of government and that of organizations is essential to maintaining momentum and pushing forward reforms to protect and stabilize our nation’s rural hospitals. While conservation can come from external elements, sustainability must begin from the inside.

Five Steps to Sustainability

The long-term survival of rural hospitals will depend on new market-driven approaches backed by innovations in technology. The following five steps cover actions and initiatives rural hospitals need to start focusing on now if they want to keep their doors open and continue providing their communities with easy access to the care they need.

Strategy 1: Prepare for Value-Based Care

Accountable Care Organizations (ACOs), bundled payments, and other new payment models are playing a large role in shifting the market from fee-for-service to value-based care. Most rural hospitals cannot afford to make the same investments in staffing and infrastructure as larger hospitals and health systems, so how can they prepare for the coming changes in reimbursement?

Increasingly, these growth strategies will be driven by new tools and technology—including customer relationship management (CRM), social media, online portals, and mobile applications—which are more targeted and cost-effective than traditional advertising or community outreach.

Since rural residents are more likely to be covered under Medicare or Medicaid, a growing share of the reimbursement to rural hospitals is going to be tied to quality and results. By taking advantage of cost-effective mobile technology and analytics-as-a-service subscriptions, rural hospitals can more effectively track and improve patient outcomes.

Strategy 2: Reduce Total Cost of Ownership for Technology Solutions

Hospital spending on information technology is trending upwards, with 2 out of 3 hospitals predicted to expand IT budgets by more than 5 percent. Hospital CIOs expect to reap the rewards of these technology investments in several areas, including compliance, quality of care, patient satisfaction, and cost savings.

As rural hospitals consider investments in health IT, they must understand the total cost of ownership of the solution—hardware, software, training, implementation, change management, and maintenance—and seek opportunities to reduce those costs.

When assessing either clinical or financial solutions, rural hospitals should look for products that offer features and functionality that are expressly designed for smaller hospitals. Choosing market-appropriate solutions will help to increase the ROI and reduce the risk of cost overruns and other disruptions that can sometimes occur when overly complex systems are implemented.

Hosted solutions offer another way to reduce the cost of ownership of health IT. Technology partners can host clinical and financial solutions for hospitals, avoiding upfront hardware expense and reducing demand for internal IT support. These solutions can help to improve service levels and ensure greater predictability in IT spending.

Strategy 3: Interoperability: Participate and Prioritize

To adapt to new payment models and drive quality improvements, hospitals must have the ability to share information with patients and across the continuum of care. Interoperability is important for both large health systems and rural hospitals, but the path for achieving interoperabil­ity for rural communities will differ.

Costs, staff bandwidth, on-site space limitations, patient and physician adoption, and technical challenges related to implementing and maintaining EHR technology, may require rural hospitals to focus their efforts in a few fundamental areas.  Take time to investigate areas where technology can yield an immediate ROI and help fund further IT expansion.

Evolution of Meaningful Use to the Promoting Interoperability Program under the Center for Medicare & Medicaid Services (CMS) Meaningful Use (MU) incentive program provides a solid foundation to help the healthcare industry focus its efforts. Read more about those guidelines in Why Participation is Key to Promoting Interoperability.

Strategy 4: Prevent Patient Leakage

Managing patient referrals and inter-provider communications to prevent leakage are fundamental to successful hospital operations. Physician referral patterns can have a tremendous impact on quality and financial results, while a negative scheduling experience can quickly taint a hospital’s reputation. Rural hospitals can now leverage online schedul­ing tools to manage patient referrals and prevent losing patients to other hospitals or health systems.

Through online scheduling, rural hospitals can better coordinate with providers by: procedure, service, geography, and other factors. Proactive scheduling can also help hospitals coordinate referral patterns and identify opportunities for improving retention.

Strategy 5: Engage Consumers to Improve Health Outcomes of Chronic Conditions

In addition to improving patient experience with well-coordinated referrals and scheduling, consumer-friendly mobile applications can help rural hospitals improve health outcomes. Newer mobile apps—some of which are now certified under the Meaningful Use incentive program—allow the hospital’s medical staff to educate patients on chronic diseases, improve follow-up visits and treatment compliance, monitor patients’ health status, and empower consumers to take a more active role in care.

Cost-effective technologies allow rural hospitals and their medical staffs to engage patients and better monitor and manage patient care by:

  • Establishing two-way communication between patients and care teams
  • Aggregating data to communicate patient progress
  • Sending reminders about follow-up visits and preventive care
  • Educating patients outside the walls of the care setting
  • Connecting patients with others undergoing similar treatments to improve adherence to care plans

However, advocacy from the top down can help provide short-term relief.  While new tools and technology can help reduce costs and these strategies can help rural hospitals improve care quality and financial outcomes, the future of rural healthcare lies with hospital leaders and their communities. When both approaches are combined into one unified healthcare strategy, rural hospitals could see long-term solutions.

Even though our healthcare system continues to change, the goals for today’s rural hospitals are surprisingly similar to those of the past. With conservative efforts and strategies designed for sustainability, rural hospitals can continue to offer the best care possible, as efficiently as possible, and keep their doors open.

Join the Conversation on Rural Healthcare:

Making Strides for Rural Health Advocacy

Podcasts: LIVE from NRHA’s Rural Health Policy Institute

Podcasts: LIVE from AHA’s Rural Health Care Leadership Conference