Keeping it Local

I ndependent health care organizations stress collaboration, local par ticipation for continued success

BY KRIS BEVILL

Lake Region Healthcare Corp., based in Fergus Falls, Minn., is an independent health care system with the goal of becoming Minnesota’s preeminent regional health care partner PHOTO: LAKE REGION HEALTHCARE CORP.

Consolidation has become a growing trend in the health care industr y as providers rework how they care for patients in the face of rising operating costs and new regulations Large systems are getting larger and independent providers are becoming fewer, which can leave one to wonder whether the days are numbered for remaining independent hospitals, particularly in rural regions like the nor thern Plains. While the going may be tough, leaders of area independents say they can continue to thrive in the changing health care environment because they serve a vital role for their communities, and stress that the support they receive locally and from other providers means they’re never alone

Larr y Schulz, CEO of Fergus Falls, Minn -based Lake Regional Healthcare Corp , is a staunch advocate for the continued independence of LRHC and says it can be accomplished through careful planning and local leadership He attributes recent consolidation in health care to a desire to distribute the increased risk being placed on providers through the Affordable Care Act, but says consolidation isn’t the only way to minimize risk

“There are different ways to accomplish the same thing,” Schulz says “In our case, we feel that working very closely with our board of directors, who are really invested in the community, collaborating with our physicians, who are very interested in our community, and working closely with our communi- ty as a whole we all support each other in that growth ”

LRHC has been able to counteract increased risk by taking its own calculated risks and providing alternatives, strategies which Schulz says have already produced successful results. Dialogue with the community has led to the establishment of a community garden to promote healthy diets for residents and an initiative to demonstrate an innovative rural health model and expanded services When LRHC set out several years ago to open a cancer center in Fergus Falls, the local community stepped up to provide all of the $10 million needed to bring the project to life

Thanks to local support and leadership, LRHC continues to expand its services and try innovative approaches to health care The organization recently began building a new, larger clinic in Fergus Falls, which is set to be complete late next year The organization also teamed up with local doctors, investors and businesses to launch a health insurance provider called Lakes Area Community Healthplan The goal of the health plan, which focuses on the greater Fergus Falls and surrounding lakes area, is to help lower the cost of health care for small businesses and help providers and employers understand each side’s issues and challenges, says Schulz.

“I think it’s up to the entire community to work together,” he says “How do we keep people well to start with so that we can reduce the total cost of care, not just the cost of health care? If we can keep people healthy to start with there will be less sick days so the company can be more productive those sorts of things ”

Boards Matter

Health care leaders say local boards of directors play a key role in the success of independent health care organizations because they allow them to better meet the needs of the community and stay abreast of looming challenges.

“They are our connection to the community to make sure that this entity is meeting the community’s needs,” says K.C. DeBoer, CEO of Jamestown Regional

Medical Center in Jamestown, N D “We are a part of the community and the community is part of us. We will only be successful as long as Jamestown is successful I think having a good board at an independent community hospital is the secret ”

Connie Krapp is the chairwoman of JRMC’s board of directors and says she is humbled by her role with the organization “Anything that I can do to enhance the medical services that we ’ re able to provide is rewarding,” she says

Krapp also views the board’s role as being a conduit between the medical center and the community it serves in order to better provide for its patients Likewise, she credits the community for fully supporting JRMC and its role as an independent provider “It’s the pride of the community and they don’t take that lightly,” she says

Local input has proven vital in guiding some independent organizations’ long-term success Electronic health records (EHR) systems are a huge capital investment for health care organizations and can be simply out of reach for smaller providers, leading them to consolidate with larger systems in order to comply with the regulatory requirement.

This is not a concern for Watertown, S Dbased Prairie Lakes Healthcare System, however, because board members there had the foresight to recommend implementing an EHR system in 2002, well before many providers even began considering them

“We were very much an early adopter,” says CEO Jill Fuller “We were able to put the capital investment into it, it’s working well for us and we continue to develop it. In fact, we ’ re moving on to the next phase of building a data warehouse so we can do the data analytics we need for more clinical integration and showing payers and the public that we have really good outcomes ”

Independent, Not Alone

Fuller says another benefit of being independent is the ability to partner with multiple entities, regardless of affiliation.

Prairie Lakes is committed to providing specialty care for approximately 87,000 people within the 10-county area it serves, but the medical center in Watertown is about 100 miles away from the nearest large health care system So Fuller says Prairie Lakes teams with both of the closest large providers Sanford Health and Avera as well as critical access hospitals in its area, to bring in primary care providers from large systems and to send out its own specialists where needed

“Our philosophy is that people should get health care as close to their own home as possible,” Fuller says “They should be able to choose their doctor.

“We like to say we ’ re independent but we ’ re not a stand-alone hospital,” she says “I think if we were isolated and in our own little world, our challenges would be incredible because we wouldn’t be keeping up with best practices But we ’ re not stand-alone ”

Schulz agrees that collaboration is a must and says LRHC is continually in contact with other independent providers as well as systems. “We continue to visit with others to talk about what we can do to strengthen not only our organization, but how do we best serve the people in our area? We do that with [independent providers]. We collaborate with our physicians all the time We also partner with systems We think that’s one of the secrets to our success is our willingness to collaborate and partner with others for those things that make sense and are in the best interest of our patients ”

Challenges Ahead

As health care demands continue to grow, independents in the region are continuing to recruit new doctors and must compete with larger systems for staff. Schulz says recruitment is always challenging, but some physicians are drawn to smaller systems and