National Rural Health Day 2015: Vulnerability to Value
By Michael Topchik, Senior Vice President
At iVantage, we’re passionate about rural people and places. Over the past five years we’ve conducted objective analysis of rural hospital performance and confirmed that the Rural Health Safety Net functions well and is worthy of the investment Medicare makes to provide “critical access” points of care to the 80+Million Americans that call rural home (including 23 million seniors).
Unfortunately, our research also suggests that 283 rural hospitals are vulnerable to closure, given the numerous policy challenges facing them. The 58 rural communities that have already seen their hospitals close since 2010 have been devastated by the loss of access to life saving care close to home. They are also hurting, quite literally, in losing access to care that so many Americans take for granted: The care for a child suddenly feverish in the middle of the night, the care for a painful fracture from afternoon sports at the local high school, or the care for a frail grandparent with pneumonia. Additionally, iVantage modeled the financial IMPACT of these closures across all 283 identified as vulnerable and found:
Value Leaders Show the Way
iVantage is proud to partner with hundreds of rural hospitals that work hard each and every day to THRIVE in these challenging times under healthcare reform. On the other end of the spectrum, our research shines a light on those hospitals that are value leaders. For the last five years we have used the Hospital Strength INDEX™ research to recognize value leaders through several programs:
- February: HEALTHSTRONG Hospitals, including 130 Rural Hospitals, that demonstrate the top statistical tier or cluster of performance of more than 4,400 US acute care hospitals
- April: the Top 100 Critical Access Hospitals CAHs across dimensions of Market and Population Strength, Value, and Financial Stability, out of the more than 1,330 CAHs in the US
- October: The Top 20 CAHs are recognized in partnership with the NRHA
- November: National Rural Health Day top performers are recognized as top quartile performers in areas of Quality, Outcomes, Patient Satisfaction and Finance among more than 4,400 US acute care hospitals
iVantage notes that these practice leaders share key attributes that position them for success in the value-based healthcare of the future. These facilities treat their role in providing this top “Quality” as an “All or Nothing” proposition, consistent with Don Berwick’s admonition that care is a pass/fail proposition…there are no “B” students.
These top performers typically score 100% on their raw measures and are frequently in the top percentiles of performance compared to peers nationally. Yes! The smallest rural hospitals CAN achieve perfect performance in the delivery of care!
More and more hospitals are being asked to evaluate the denominator of value: Pricing. We must look at the question “At what Cost”? Top performing rural hospitals work hard to provide the best clinical care at the lowest cost. We see the industry working hard to take 5-6% of their costs out of the system each year, targeting a 5-year, 25%-30% cost reduction.
The healthcare industry is in the midst of its shift from “volume to value”. Many are already receiving alternative, volume based payments. This means that we will all be forced to chase the value curve, offering the best clinical care at the lowest possible cost. Finding opportunities for improvement in these early years is paramount to the success of the rural health safety net of the future, and it will become more and more challenging as peers seek to do the same. The practice leaders we recognize today are off to a great start!
Congratulations to all top performers on National Rural Health Day 2015!