CEO Update: The Luck of the Irish
I was so lucky this past month to visit Ireland. What a beautiful country: so green, unlike Colorado’s desert landscape. While my husband and I were in Ireland to celebrate our 25th Anniversary, we took a few tours. Since talking is my superpower, I of course struck up a conversation with a couple of the tour guides and discovered that they were trained health professionals; one a doctor and one a lab tech that had decided to leave the medical field. I was intrigued as to why these folks were working in tourism instead of their trained profession. What I learned was that in their opinion, the healthcare system was a mess, with long, unreasonable wait times, despite the fact that care was more affordable in this country. This got me thinking that as a county, Ireland too is working on resolving their healthcare issues, just as we are in the U.S. 
We know that currently 22 rural hospitals are operating in the red, compared to 11 last year (according to iVantage data). With generally declining populations, aging patients, and fixed costs due to low volumes, financial and operational improvement remain vital. One way CAHs are working to tackle some of the real barriers of the population they serve, primarily Medicare and Medicaid (18% – 78%) is by expanding out services through their Rural Health Clinics (RHCs). Unfortunately, expansion of services alone cannot accomplish a fiscal turnaround. It takes careful examination of all aspects of the system. With no federal funding to help offset the population they serve or support the movement towards population health and the fact that their payment is half of what a Federally Qualified Health Center receives, you can see why the business model is not working in many rural communities. This is not only the case in Colorado. You can see it across the county with 97 rural hospital closures since 2010, according to the National Rural Health Association. We all know that when a rural hospital closes, generally the town suffers as healthcare is one of the top three employers in the county.
All is not doom and gloom though! CRHC’s Improving Communications and Readmissions (iCARE) program working with 23 rural communities to improve communications in transitions of care, maintain low readmission rates and improvement clinical processes is yielding results. Participating rural clinics have achieved 91% A1c tests performed of their diabetic patients, 79% of their patients have their A1c under control and 59% of their patients are controlling their high blood pressure. CAHs have a 3.5% readmission rate for same/similar diagnosis and have decreased their frequency of low level severity emergency visits over the last year by 7%. Additionally, 91% of communities have started a patient and family advisory council that is engaging in quality improvement activities on behalf of the community.
All these topics and more will be discussed next week at CRHC’s Annual Forum Conference, a conference designed to meet the needs of our RHCs. There is still time to register – to join us, visit our website here!
Looking forward to seeing everyone next week.
