Time to Reinvent Rural Healthcare?By: Monte Regier

During COVID-19 health systems had to scramble to shift care delivery to meet the anticipated demand of millions of critically sick people in need of care. Managing the pandemic was difficult, our systems were stretched to the brink, and thankfully the predictions were overstated. The health leaders I interact with believe they have learned how to handle COVID-19, but the crisis is far from over.

The American Hospital Association projects 2020 hospital losses from the pandemic will run over 320B, impacting the United States health systems for years with many forced to close their doors. These disrupting events have left health systems in a continued state of panic over where they will need to cut next and what do they need to do to stay viable.

None of us likes to change. We remember the many good things in our past and hope we can return to what seemed comfortable. For those of us who have been working in healthcare for years, it seems like we have been in a constant state of change for some time. With even tighter financial constraints and a marketplace where profitable revenue streams are changing, if there was ever a time to re-think our healthcare delivery model it is now.

Reinventing our rural health systems in a way that expands access, improves quality, and meets the challenges of the 21st century will require real innovation. We cannot focus on costs alone and expect to survive. Our guiding change principals must focus on what is the right medical delivery model to ensure that we can deliver the highest quality of care. The list below is a good example of guiding principles offered by the Washington State Health Authority:

  • Rural health transformation should preserve access to local health services in rural settings.
  • We must consider the unique circumstances of each rural health facility, and ultimately offer a flexible path toward transformation.
  • Alternative payment will be tailored to the provider’s capacity to take on risk and will be phased in overtime.
  • Participating rural health systems will customize care redesign and transformational approaches within a general framework that meets the needs of their communities.
  • Moving to a value-based model should support – rather than add to – rural providers’ existing transformational efforts.
  • Rural health transformation should contribute to better patient outcomes and better population health.
  • Acknowledge the up-front costs and investments for the implementation of new payment models.
  • Consider the effects of reduced volumes, increased costs, and changes in health care delivery methods when assessing the transition to new payment models.
  • Use the best and most current data available to guide our work and decision making.

Our change process must be guided by data that will truthfully inform change decisions and promote actionable activities in an evolving model. Our data must inform us of our health system health in every operating division, department and line of business of our enterprise. Our patients expect this from us, and we make hard decisions and give them informed choices for their best care. We need to be of the mindset to do the same for the health of our health systems.

Published on 10/23/2020

Authored by Monte Regier, MS