"We haven't had the luxury of what the large market gets," he says. "There are models now that will hopefully let us leverage that through the public exchanges or even private exchanges such as the one we have with Medica (a Minnesota health plan). We're the low-cost option. That will help our community based ACO model to have a larger economic footprint."
Its geography and independence are stepping stones toward more accountable care and a reimbursement regime that will help Ridgeview thrive, Phelps says.
"We're in a desirable mix of urban and rural markets that are part of the referral sources for the big guys," he says. "Everyone wants a piece of you and it puts you in a good negotiating position."
An example of a project that wouldn't have been possible without independence and that good negotiating position is a neonatal ICU started at Ridgeview in a partnership with two children's hospitals.
"We ended up with great relationships with children's hospitals and clinics in Minneapolis," he says. "Our independence is the critical thing that got that here."
All this to say that if you lead a small health system like Phelps, you do have options besides being acquired by a bigger partner. You just have to actively seek them out and execute on them, because time is not on your side.