It’s a difficult conversation, much like a “Dear John Letter.” For 75 years, we’ve been your community hospital, a publicly-owned, independent pillar of local healthcare. We cherish the long-standing relationship with the county commission and community, appreciating the support that has sustained us through the decades. Your commitment, reflected in thoughtful board appointments and even increased millage rates, has been invaluable. We reciprocated with unwavering service, providing stable jobs, attracting businesses, and ensuring local access to essential healthcare. Those were truly remarkable times, partnerships we deeply value.
However, the landscape has shifted. Our community has evolved, and so has the healthcare industry. The traditional model of community-funded, independent hospitals is facing unprecedented challenges. It pains us to acknowledge, but the current level of support may no longer be sufficient to deliver the comprehensive care our community deserves. The time has come to consider a difficult but necessary step: exploring new partnerships. It may be time to consider letting go of the exclusive relationship we once had. How did we arrive at this juncture?
Since our doors opened in the 1940s, our community’s demographics and needs have undergone a significant transformation. Once a relatively isolated town 60 miles from the nearest city, with a thriving local economy, we were the primary healthcare provider, meeting most local needs and welcoming numerous newborns into the world each week.
But demographic shifts have taken their toll. Younger generations have sought opportunities elsewhere, leading to a decline in local employers. Consequently, funding essential community services like schools, roads, and, crucially, healthcare, has become increasingly challenging due to a shrinking tax base.
Simultaneously, the healthcare industry itself has been revolutionized by escalating costs and evolving service delivery models. The expense of providing modern medical care has skyrocketed, encompassing everything from attracting and retaining qualified nurses and medical professionals to investing in cutting-edge technology and maintaining modern facilities. These costs continue their upward trajectory, while reimbursements for services are simultaneously decreasing. This creates an unsustainable financial equation for independent community hospitals. How often can local taxpayers be expected to shoulder increasing financial burdens to maintain the current system?
The era of community hospitals serving as the sole healthcare hub is fading. Patients now frequently travel to larger urban centers and renowned medical brands for specialized care. These larger healthcare systems, in turn, are expanding their footprint, establishing clinics and physician offices in wealthier and growing suburban areas. Our own delivery rates have dwindled to around 20 births per month, a volume that raises concerns about maintaining optimal proficiency in obstetric care, as research indicates that higher delivery volumes are correlated with better outcomes.
Continuing on our current path is simply not viable. We require not only consistent financial support but also access to resources that would be fiscally irresponsible, if even possible, to acquire independently. To ensure the long-term health and well-being of our community, we must become part of a larger, more robust healthcare ecosystem.
While maintaining the status quo might offer short-term comfort, it is a path to long-term instability and decline. Delaying necessary change risks a far more damaging outcome: dwindling cash reserves and the painful erosion of essential services, ultimately culminating in the specter of bankruptcy – a scenario no one desires.
Therefore, the prudent and forward-thinking approach is to conclude our exclusive operational model and proactively explore partnerships and alliances with larger healthcare organizations.
This is not an isolated situation. Across the nation, county commissions, city councils, and boards of non-profit community hospitals are recognizing the need for strategic realignment. Many are actively pursuing alliances, partnerships, and even acquisitions by larger healthcare systems to secure their future viability. These strategic relationships offer numerous benefits, including expanded service offerings, improved access to specialized care, and enhanced clinician recruitment capabilities.
We understand that change can be unsettling. Relinquishing local control and potentially ceding some local jobs represents a significant departure from our historical relationship. However, clinging to an unsustainable model risks a far greater loss: the potential disappearance of local healthcare jobs altogether.
Still hesitant? Understandably so. But consider these critical questions:
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Is overseeing a modern healthcare system truly the most effective role for the county commission? Healthcare today is an exceptionally complex, expensive, competitive, and politically sensitive sector. The traditional role of acute-care facilities is undergoing a dramatic transformation as both government and private payers increasingly prioritize value-based care models. If providing quality healthcare is challenging now, it will only become more demanding in the future. Is this an escalating liability the county wishes to bear?
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Are there established and reputable healthcare providers already operating in our region? The presence of larger healthcare brands establishing a local presence could indicate potential partnership opportunities. For these organizations, aligning with a community hospital like ours could strategically expand their regional network while simultaneously fulfilling our mission of ensuring continued local access to high-quality healthcare services.
Exploring partnership options should not be perceived as abandoning our community or relinquishing responsibility for local healthcare provision. Quite the opposite: it is an active step to secure its future.
The encouraging reality is that community hospitals like ours possess valuable assets that are attractive to larger healthcare partners. These include established service areas, existing real estate and facilities, skilled and dedicated healthcare professionals, and, crucially, the trust of the community we serve. This trend is already evident nationwide. Currently, over 60% of the 5,157 hospitals across the U.S. are integrated within larger healthcare systems, benefiting from the stability and resources these relationships provide. Conversely, government ownership of hospitals has decreased by nearly 30% since 1995, highlighting a national shift away from independent, publicly funded models.
Moreover, the county commission’s endorsement and support for a strategic partnership would be a significant political advantage highly valued by any potential partner.
We are approaching this juncture from a position of strength, a position that allows us to advocate effectively for our community’s best interests.
Undoubtedly, a partnership will usher in change. We will not be the same as before. But in a constantly evolving healthcare landscape, adaptation is essential. It is time to embrace this change, to transition from our current model and collaboratively build a new, more resilient, and sustainable healthcare future for our community.
We wish ourselves, and you, the very best in this crucial transition.
With hope for a healthier future,
Your Community Hospital
Contributors: Tim Stewart, Letitia Fecher, Emme Nelson Baxter, David Shifrin
Image Credit: Shannon Threadgill
