AHA Rural Chair: Reimbursement Top Challenge

John Commins, for HealthLeaders Media , January 23, 2013

Performance improvement programs at small hospitals need a cultural shift, where each employee is empowered to have a voice and make changes and believe that when they have an idea and bring it forward someone is going to consider it.

We've got to figure out how to get the waste out of our system. We want to figure out how to get people out of the waiting rooms and getting care. We have to learn how to be efficient with resources, whether it is human resources or supplies, the actual care that we give, we want to be as efficient and safe and effective as we possibly can.

HLM: Given challenges like economy of scale, low volume, and patient migration, should small and rural hospitals reassess the services they are offering?

AH: We all have to examine our service lines and see what we can afford to do well. But it's foolish to think that small and rural hospitals should throw in the towel.

Who lives in rural America? Elderly people live in rural America. How difficult is it for them to drive down the road for an hour to get care? By golly it's better for them to get care at home in small town America where they have the friends and support versus driving to a big town.

The people who live in my community don't want to drive to big towns to get their healthcare. The folks who bypass you are folks with means and the ability to pay and who have children who can drive them back and forth. But a lot of people in rural America don't have that luxury.

John Commins is a senior editor with HealthLeaders Media.

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