TS: I don’t think any one corporate model is inevitable in our country given the value we place on independence, inventiveness, and the underdog. But it isn’t my place to say what a rural hospital should or will do with such a sensitive issue. There are many examples of both “independent” and “system” hospitals excelling at serving their local communities. We clearly are in a time of significant uncertainty. During such times, we see a spike in mergers and acquisitions in any sector.
GS: What are some of the specific trends that will help rural organizations find their place in the healthcare market landscape of the future?
TS: In the long run, there are at least four trends that I believe will continue to support locally based organizations as part of the mix.
First, all providers are increasingly incented to work collaboratively so the distinction is fading between independent and system.
Second, advances in telehealth and electronic support services will give local hospitals more choices in where and how they gain assistance in maintaining local care.
Third, the imperative and benefits of hospitals working with their communities to create health will definitely favor those with the strongest local connections.
And last but not least, health reform will tend to level the playing field between primary care and specialists (and their related hospitals). The overpayment of specialty services will be less available to fuel the corporate acquisition and subsidization of rural hospitals. I believe it is likely that we will see a healthier balance between the power of capital and the power of place.