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Critical Access Hospitals Need Not Be Endangered Species

by Brad Huerta, CEO, Lost Rivers Medical Center

“Survivor,” the evergreen reality television show, captures people at their most vulnerable. Around the world, viewers rest on their recliners and witness a select group of people discovering a deserted location, struggling to forage, eager to create pacts, relying upon their sheer wits and brute strength—and constantly under the threat of elimination.

At the risk of sounding cliche, I’ll say that rural hospitals—the survivors of the healthcare industry—aren’t so different from the show’s contestants.  We are lean and agile, and we are fighting to survive in an age where our peers continue to close at alarming rates.

In rural communities across the nation, community and critical access hospitals are shutting their doors, driven to insolvency by Medicare spending cuts and  an environment with lower-than-average patient volume.  In the past five years, the rate of closures has increased six fold. The National Rural Health Association estimates that about 35% of rural hospitals operate at a financial loss.  Most others are operating at only the narrowest of margins. 

Take, for example, the critical access hospital that I oversee, Lost Rivers Medical Center. We are a rural medical center in Idaho comprised of one community hospital and two clinics. We’ve carved ourselves a nook in the mountainous Midwest wilderness and have sunk our roots here. We provide care for a large region of Idaho, but our patients number fewer than 8,000—so few that the census bureau categorizes us as “frontier” territory. Because there are no other immediate sources of care for the Arco, Idaho community, we at Lost Rivers literally do it all.  And as a Critical Access hospital, we need to remain accessible and prepared for those who depend on us.

Lost Rivers Medical Center is certainly not alone: according to the American Hospital Association, approximately 82% of all hospitals in the US have fewer than 250 beds. It is important that these small but necessary outposts of care not get lost in the shadows of big hospitals.

When you’re surrounded by open acres, you have to take advantage of the freedom that offers.  Sometimes, that means breaking from the healthcare rank-and-file and approaching old problems with fresh ideas.

For Lost Rivers, that meant deciding not to go it alone and embracing partnership.  Our hospital was the first in Idaho to utilize telepharmacy.  In 2015, we joined athenahealth’s network to tap into its services, knowledge, and back-office work.  Since then, we’ve experienced the benefit of connections to 80,000 of our peers across the country to help our staff work smarter, faster, and with renewed purpose.

And it’s not just our knowledge and financial health which are growing.  So is the expertise of other connected hospitals. In just over a year, athenahealth’s hospital client base more than tripled in size, contributing to network insights that benefit us all.

Promoting value-based and patient-centered care, backed by network-enabled services, is the best way I’ve found that small hospitals can access knowledge and insight to augment scarce resources, while remaining fully devoted to their patient base. Being on the network allows frontier hospitals like mine to embrace their remoteness without feeling alone.

I’m able to call the Lost Rivers Medical Center a critical access, community-based, frontier hospital, and find strength in these labels, knowing that we’ll do much more than survive out in the wilderness—we’ll thrive.

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