Rural hospitals are critical to the communities they serve, but in many areas their role is changing. Demographics tell the story. Patients tend to be older, and many are uninsured. Populations are declining. The decreases result in fewer inpatient admissions, but they have not reduced the need for emergency care or primary care physicians. The U.S. Census Bureau reports that 20% of the U.S. population is rural, but only 12% of primary care physicians are working in rural areas — and their numbers per capita are declining.

All of these factors make it more challenging for a rural hospital to maintain community health, and they also threaten the hospital’s financial viability. The challenges also create difficulty for employees, patients and the surrounding community who depend on the hospital’s continued success. With so much at stake, how can hospitals achieve better financial performance in the face of so many challenges? Here are five bottom-line boosting actions to take.

1. 1. Identify areas needing improvement. Begin by looking at the basics. This can have a big impact, as was the case when Yoakum Community Hospital in Yoakum, Texas, started qualifying the payer status of patients prior to admission. Self-pay patients may qualify for Medicaid or another reimbursement source, so this single (and relatively simple) step significantly increased revenue.
   2. Strengthen physician relations. Hospital-physician collaboration can improve quality and cost efficiency. It might also create a culture that attracts and retains much-needed physicians. At Great Plains Health, North Platte, Nebraska, physicians hold leadership positions to enhance relationships between their ranks and hospital executives. Physicians have a strong voice in the organization’s strategic decisions. It’s also important to evaluate overall physician mix and create or revise your medical staff development plan as needed. A large part of a hospital’s growth and success depends on the right mix of physicians and specialists.
   3. Benchmark performance against similar hospitals. Comparing clinical, operational and financial data almost always results in identifying opportunities for improvement and cost savings. The process helps to identify where to allocate time and money for improvement initiatives. Benchmarking also facilitates movement toward value-based care.
   4. Think about partnerships. If internal improvements aren’t sufficient, community hospitals might consider forming relationships with other organizations. Analyze the advantages and disadvantages of various partnerships as well as potential partners. Mission alignment and due diligence are critical. In certain cases, CHC steps in to keep hospitals going until they find the right partner.
   5. Ensure board education and involvement. A South Carolina Rural Health Research Center survey found that only 59% of hospital CEOs strongly agree that board members clearly understand their role, and the majority stated orientation for new board members is lacking or non-existent. When board members are better educated about their responsibilities, their support and ideas can be invaluable.

Financial stability through these five steps and other actions enables rural hospitals like yours to continue serving as a healthcare safety net for smaller communities. Learn more about how CHC is helping hospitals help communities.

By Joe Thomason, SVP Hospital Operations May 14, 2020 Financial Performance, Operational Improvement, Hospital Turnaround, Strategic Direction