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Optimizing Rural Health: a Community Healthcare Blueprint

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Optimizing Rural Health: a Community Healthcare Blueprint Optimizing rural Health a community healthcare blueprint In partnership with Table of Contents Acknowledgements ........................................................................................................................ iii Foreword ........................................................................................................................................ iv Funders’ Foreword ...........................................................................................................................v Executive Summary ....................................................................................................................... vi Section 1: Introduction & Status of Three Communities in Rural Texas ........................................1 Introduction ..................................................................................................................................1 A Series of Case Studies...........................................................................................................2 Community 1 .......................................................................................................................7 Community 2 .....................................................................................................................17 Community 3 .....................................................................................................................25 Discussion of Findings and Commonalities ...........................................................................38 Section 2: Common Blueprint of Rural Communities ...................................................................49 Web Based Dissemination .........................................................................................................49 Common Blueprint .....................................................................................................................51 Community Awareness ......................................................................................................51 Community Service Organizations ........................................................................52 Community Health Assessments ...........................................................................54 Transportation Concerns ........................................................................................56 Relationships with Media ......................................................................................57 Social Media ..........................................................................................................58 Patient Feedback: Transparency in Quality ...........................................................59 Community Engagement ...................................................................................................60 Need for Community Engagement ........................................................................61 Community Health Resource Center ....................................................................62 Patient Surveys.......................................................................................................63 Redefining Access .............................................................................................................64 Service Lines ..........................................................................................................65 Due Diligence Evaluation of Existing Lines .........................................................65 Swing Beds ............................................................................................................67 Telemedicine ..........................................................................................................68 Optimizing i Hospital Board Leadership ................................................................................................69 Contracting Issues ..................................................................................................70 Education Programs ...............................................................................................71 On-Boarding Process .............................................................................................72 Strategic Planning ..................................................................................................73 Finances .............................................................................................................................74 Third Party Contracting .........................................................................................75 Optimizing ii Acknowledgements We acknowledge our partnership with Episcopal Health Foundation, Robert Wood Johnson Foundation, and the T.L.L. Temple Foundation. Their support was instrumental to this work and greatly appreciated. We also appreciate the contributions of the Texas A&M Rural and Community Health Institute (ARCHI) team. Significant contributors include: Nancy W. Dickey, MD, Bree Watzak PharmD, and Angela Alaniz, BA. In gratitude for their valued perspectives the authors would like to acknowledge our National Advisory Board Members: John McCarthy, M.D. Assistant Dean for Rural Programs, University of Washington School of Medicine Mark Jones, BS, N.R.P. Executive Director at the Minnesota Rural Health Association Matthew Kuhlenbeck, M.H.A. Program Director at the Missouri Foundation for Health Steve Michaud President of the Maine Hospital Association Tom Morris, M.P.A. Associate Administrator at HRSA’s Federal Office of Rural Health Policy Paul Moore D. PH Senior Health Policy Advisor at HRSA’s Federal Office of Rural Health Policy Ken Roberts, Ph.D. Vice Dean for Academic and Community Partnerships at Washington State University College of Medicine Paul Roth, M.D., M.S. Executive Vice President and Chancellor for Health Sciences at the University of New Mexico Health Sciences Center Suggested Citation: Texas A&M University Rural and Community Health Institute (ARCHI). (2018). Optimizing Rural Health: A community healthcare blueprint. Retrieve from https://architexas.org/rural- health/activities.html Optimizing iii Foreword The Rural Health Team at the A&M Rural and Community Health Institute (ARCHI) has been honored to work with our funding partners in evaluating the status of rural health care delivery in Texas and particularly in beginning to seek solutions to the challenges faced by small towns and their hospital facilities. The commitment of these philanthropic organizations to the people living in the rural parts of our country brings hope and new ideas to communities that often feel they have been forgotten. As a result of the work funded by Episcopal Health Foundation, the Robert Wood Johnson Foundation, and the TLL Temple Foundation, ARCHI has been awarded funding by the Health Resources & Services Administration to create a technical advisory center for the vulnerable rural hospitals across the United States. The financial support as well as the philosophic enthusiasm of these organizations helped motivate the early work that led to the development of the Center for Optimizing Rural Health. The people who live in rural Texas benefit from the continued thoughtful investment by philanthropic organizations and the ongoing encouragement by the leadership of those organizations to continue to look for innovative programs to address rural health care challenges. The US health care delivery system is undergoing continuous and ever more rapid change; rural communities must find ways to survive and even thrive in that changing environment. Through academic/philanthropic partnerships, those communities can be provided possible options for meeting the change. Optimizing iv Funders’ Foreword In 2016, the Episcopal Health Foundation (EHF) engaged the Texas A&M University Rural and Community Health Institute (ARCHI) to better understand the scope of the rural hospital crisis in Texas. The report, entitled “What’s Next? Practical Solutions for Rural Communities Facing a Hospital Closure,” was released in May 2017 and has attracted widespread attention from policy makers and stakeholders in rural communities in Texas and beyond. The report outlined a range of practical options for Texas communities facing a rural hospital closure. In late 2017, EHF invited the Robert Wood Johnson Foundation and the T.L.L. Temple Foundation to join forces in supporting ARCHI to conduct year-long, in- depth case studies in three rural Texas communities facing hospital closure. The purpose of these case studies was to learn more about the specific ways each community responded to this challenge. In this new report entitled “Optimizing Rural Health: A Community Healthcare Blueprint,” ARCHI builds upon its previous research and delves deeper into what influences hospital closure and what prevents closure. Additionally, the report includes a practical set of blueprints to optimize rural healthcare delivery in Texas. ARCHI’s research team conducted interviews with hospital board members and held focus groups with community members. The resulting, rich case studies illustrate that access to quality care is much more complex than distance to services. Transparency, quality, and community engagement are also critical factors to the future of rural healthcare. One of the report’s key messages is the importance of recognizing each community’s individuality. However, the critical decisions needed to move forward and optimize rural healthcare delivery primarily
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