Partnerships to improve rural and community hospital performance

Increasingly, hospital CEOs are seeking alliances with strategic vendors and other health care organizations to overcome financial challenges and maintain vital health care services.

Relationships play a pivotal role in the sustainability and growth of community hospitals. These alliances allow resource-constrained facilities to tap into a wealth of information, technology, and expertise that may otherwise be cost prohibitive. 

In some situations, partnerships allow community hospitals to expand services, such as introducing telemedicine and offering specialized care like cardiology and podiatry, which might not be feasible independently. In other cases, partnerships provide access to best practices that enhance the overall quality of patient care. 

Collaboration is instrumental for increasing patient satisfaction and improving community health, along with solidifying the hospital’s vital role within its community. 

Exploring partnership options

The process of finding partners should be tailored to a hospital’s unique needs, strengths, and challenges. The chosen relationships should aim to enhance revenue or reduce cost while supporting quality of care, patient satisfaction, and overall community wellness.

Before seeking partners, hospitals should identify their strengths and the areas requiring additional resources and support. Defining objectives and requirements up front also helps streamline the process by defining search criteria. Potential objectives may include improved geographic coverage, clinical integration, care delivery efficiency, expanded services, cost reduction, or enhanced clinical talent.

It’s also helpful to consider partner alignment with the hospital’s mission, culture, and resource needs. Shared goals offer mutual benefits.

Growth through partnerships

Depending on a hospital’s needs, there are a variety of relationships that can create growth:

• Service expansion through vendor partnerships: Several hospitals have successfully introduced telemedicine, hospital-at-home services, and wound care using vendors who provide turn-key services.
• Service expansion through itinerant physicians: For specialties like cardiology, general surgery, pain management, and podiatry, visiting physicians can enable a hospital to expand services and open new revenue streams.
• Service expansion through clinical affiliation: This specific level of affiliation enables the smaller facility to offer specialty care through telemedicine and/or access to specialty physicians who rotate and offer services on certain days at the smaller hospital. In return, the smaller hospital agrees to transfer its more complex cases related to that specialty to the larger clinical affiliate partner.
• Hospital performance improvement through a management agreement: At times the local hospital board may want to maintain governance and control over the hospital while abdicating day-to-day management responsibility to a third party that offers more resources. Short-term or interim management relationships may occur when a local CEO leaves the organization and no suitable replacement is readily available. Long-term management relationships occur when the board desires an experienced, reliable third party to oversee the day-to-day operations of the facility.

As one example, Community Hospital Corporation (CHC) helped a critical access hospital in New Mexico bring in itinerant specialist physicians once or twice a month to provide care. Not only was the hospital able to better engage the community with expanded local services, the volume of related invasive cases increased 350 percent within about two years. The hospital’s advocacy efforts with the state also helped in securing additional support through supplemental funding. 

In Nebraska, CHC worked with a regional health system that reached out to smaller area critical access hospitals, allowing their employed specialists to “do what you can in that community” so patients did not have to travel for specialty care. 

Similarly, a critical access hospital in Colorado that wanted to expand cardiology services partnered with an area mid-size community hospital that provided an onsite cardiologist, while higher-end cardiology services were provided at the larger facility. It’s a different mindset – one of collaboration – that allows both partners to benefit from the new relationship and revenue. 

A small Texas community hospital chose to align with a technology innovator for expanded services through its ER. Although the project is in its early phases, progress is promising. The hospital has been able to provide more services through telemedicine, retain more patients, and care for a higher level of acuity rather than transferring patients out to another facility. 

Best practices for partnerships

When pursuing a potential partnership, be flexible, take the time to do a thorough assessment, and be aware of any potential risks. Clear communication, due diligence, and regular evaluation of the partnership’s effectiveness are critical in forming a successful alliance.

Strategic partnerships are more important than ever in today’s evolving health care landscape. With the right partner, hospitals can adapt to changes, simplify complexities, and maintain their financial viability.

NRHA adapted the above piece from Community Hospital Corporation, a trusted NRHA partner, for publication within the Association’s Rural Health Voices blog.

About the author: Joe Thomason is Senior Vice President of Hospital Operations for Community Hospital Corporation. He has more than 30 years of experience in multihospital operations, strategic market and partnership development, physician recruitment/development and performance improvement, and a decade in community hospital CEO roles.