Cary joins hospitals to help launch rural health cooperative

Five hospitals in Maine, including three in Aroostook County, have announced the formation of the Maine Rural Health Collaborative, LLC, with a goal of preserving and enhancing healthcare within the communities they serve.
The hospitals include: Northern Maine Medical Center in Fort Kent, Cary Medical Center in Caribou, Houlton Regional Hospital, St. Joseph Hospital in Bangor and Mount Desert Island Hospital in Bar Harbor. The formal announcement of the collaborative was made at a meeting of the five hospitals’ chief executive officers and members of their boards of directors, held recently in Bangor.
Tom Moakler, Houlton Regional Hospital CEO, has been appointed the first chairman of the collaborative operations committee. Moakler said that the timing for the development of the organization comes at a period of change in healthcare.
“The advent of the Affordable Care Act, changes in reimbursement, and a number of other complex issues are reshaping the landscape for hospitals and other healthcare providers across the nation,” said Moakler. “Our hospitals here in Maine are coping with these changes while facing unique challenges in providing healthcare to a rapidly aging and low income population, particularly in rural parts of the state. By working together in a collaborative fashion we can all benefit from each other’s experience, standardize best practices and protect quality, accessible care.”
According to a recent report by the American Hospital Association, titled “The Opportunities and Challenges for Rural Hospitals in an Era of Health Reform,” 72 million Americans or 22 percent of the nation’s population live in rural areas and depend upon the hospital serving their community as an important and often the only source of care. Rural hospitals across America are facing multiple challenges including an aging population, higher rates of chronic illness, higher rates of poverty, an aging workforce and an over-dependence on government programs like Medicare and Medicaid, programs that often reimburse rural hospitals less than the cost of the care they provide.
According to Cary CEO Kris Doody, RN, MSB, these challenges have propelled rural hospitals across the country to consider forming networks to find new solutions.
“It is clear that current demographic trends and the demands they place on rural hospitals taken together with the impact of the Affordable Care Act require new and creative approaches,” said Doody. “This new Rural Health Collaborative will bring together hospital and trustee leadership to share ideas and best practices that may lead to different delivery systems, shared information technology, and other strategies to pro-actively meet these rising challenges.”
Rural hospitals are frequently their communities’ largest employers and often stand alone in their ability to offer highly skilled jobs. This is the case in many rural Maine communities. Peter Sirois, CEO of Northern Maine Medical Center in Fort Kent, pointed out that his community hospital plays a vital role in the overall economic health of the St. John Valley.
“We are the largest employer in Fort Kent,” said Sirois. “The jobs created at the hospital multiply jobs in the community that provide services or materials for us. We also are a critical link for the university here and their nursing program. It is the same for all of our hospitals in the collaborative and underscores the need to work together to keep our hospitals strong.”
Another factor cited in the AHA report contributing to the challenges of rural hospitals is geography. Residents in rural areas often face barriers in accessing healthcare services. Patients may live miles away from the hospital and most rural areas have poor or non-existent public transportation. Patients often delay seeking care, which can aggravate health problems which may lead to more expensive interventions upon receiving care.
Mary Prybylo, RN, MSN, CEO at St. Joseph Hospital, said by working together the health collaborative will be looking for ways to improve access to care, particularly preventive services.
“All of our hospitals are doing great things to educate patients about how to manage chronic disease,” said Prybylo. “We have diabetes education programs, programs on heart disease and asthma and many others. By working together we can identify programs that are working the best and replicate them so that patients can be more engaged in self-care and prevent complications. Advancing technologies may also benefit us in this effort by being able to deliver some of this education on line reducing the patient’s need for travel.”
The shortage of primary care physicians also impacts rural hospitals. Art Blank, CEO of Mount Desert Island Hospital in Bar Harbor, said that physician shortages and the aging healthcare workforce are issues that the collaborative will want to address.
“We are all facing the challenges of physician recruitment and other manpower issues,” he said. “Individually we have all tried various ideas to improve upon the situation, but it is still a significant challenge. By coming together we can discuss solutions and bring our voice to the table advocating for state and federal policies that will provide incentives for health professionals to serve in rural communities.”
The idea of establishing collaboratives and regional networks to address the challenges facing rural hospitals is not a new concept, Moakler indicated.
“We have learned about a number of initiatives that have brought rural hospitals together,” he said. “Georgia, New Hampshire, Illinois, and other predominantly rural states have created a variety of structures to deal with some of the same issues we have discussed here. We hope to learn from their experiences so as not to reinvent the wheel while at the same time bringing our own unique perspective to the challenges and opportunities.”
CEOs and members of their hospitals boards of trustees have begun regular meetings, formed a business model and have finalized and approved a strategic plan and budget for the organization.
Peggy Pinkham, RN, MBA has been hired as the executive director for the Maine Rural Health Collaborative. Pinkham is a former hospital CEO and for the last six years has done healthcare consulting primarily in Maine. She also works with the State of Maine Rural Health and Primary Care Program and Maine’s Critical Access Hospitals focusing on education, as well as sharing best practices in quality, financial and operational improvement.
Pinkham earned her MBA at New Hampshire College.