The Enid News and Eagle, Enid, OK

Progress 2013

February 23, 2013

The challenges of rural health care

Communities continue to find ways to keep health care facilities open, services available

ENID, Okla. — As the nation’s health care industry adjusts to implementation of Patient Protection and Affordable Care Act, or so-called “ObamaCare,” some of the greatest challenges and changes may be seen in delivery of health care to rural areas.

Autonomous rural hospitals, already in decline before 2010, are increasingly moving toward affiliation with larger, corporately-held hospitals to better manage the bureaucratic requirements of new federal health care mandates.

Changing models

Jeff Tarrant, president of Integris Bass Baptist Health Center, already is familiar with the model of rural clinics connected to larger metro hospitals.

From Enid, Integris staffs and manages clinics in Garber, Hennessey, Medford, Waynoka, Cherokee and Caldwell, Kansas.

Tarrant said some of the affiliated rural clinic staff work full-time at their clinic location, while others split their time between Enid and the remote clinics.

He said staffing rural clinics is “based on the size of the community and the need for our presence.”

Integris also works out of clinic space in rural hospitals, as it does at Seiling Municipal Hospital.

The challenge for any rural health care provider, Tarrant said, is in filling the patient volume needed to meet staff and facilities overhead.

“That issue is typically related to community size, and with a clinic in a community the size of Waynoka — that’s a wonderful service and it’s a wonderful community, but there’s a fixed overhead expense just to have that facility open, and it’s a challenge.”

Tarrant said many communities, like Waynoka, would not have local health care without affiliated clinics.

“That’s a great example of a community that, without that clinic being there, people would have to travel quite a ways to receive care, and we see that as an extension of our mission.”

Tarrant said challenges of patient volume in rural areas can be overcome by tailoring services to community needs. He said that kind of creative efficiency becomes more necessary as the federal health care law reaches full implementation.

“I’d like to say (the future of rural health care) is as bright as ever, but the tone for health care across the country is that things don’t get easier from here,” Tarrant said. “They’re going to get tougher. I hope that’s a message to our industry that we need to operate more efficiently. I would be shocked if we don’t see some evolution of how things have traditionally been done.”

Tarrant said that evolution in rural health care likely will entail most unafilliated rural hospitals seeking affiliation with larger providers, in order to benefit from larger administrative structures and stronger purchasing power.

“In terms of gaining efficiencies and economies of scale, having an affiliated provider can help make those hospitals a more financially viable option,” Tarrant said. “I think we will see more of that affiliation, and smaller hospitals will look for affiliation to gain that economy of scale.”

He said affiliation isn’t something that should cause concern for rural residents.

“If that (affiliation) solidifies the delivery of health care in some of the communities in northwest Oklahoma, I think that’s something even the communities should celebrate,” Tarrant said. “The loss of autonomy is a lot less onerous than the potential loss of health care.”

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Progress 2013
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