Thriving as a small or midsize hospital: 6 CEOs weigh in

Small to midsize hospitals must constantly work to establish a delicate balance between offering valuable services and care to their communities without raising expenses.

In a panel at the Becker's Hospital Review 5th Annual CEO + CFO Roundtable on Nov. 8 in Chicago, six healthcare CEOs shared advice on how to maintain successful small and midsize hospitals.

Panelists included: Alex Rintoul, CEO of The Medical Center at Elizabeth Place in Dayton, Ohio; Larry Schroeder, CEO of Sauk Prairie Healthcare in Prairie Du Sac, Wis.; Emmett Schuster, president and CEO of Gibson General Hospital in Princeton, Ind.; Maria Ryan, PhD, CEO of Cottage Hospital in Woodsville, N.H.; and Chris Grottenthaler, founder and CEO of True Health Diagnostics in Frisco, Texas.

Here are the top soundbites from their discussion, lightly edited for clarity.

Valuable strategies to thrive in today's healthcare climate:

 

Mr. Schuster said, "Every health system, whether large or small, has to be responsive to the community. If we're trying to provide something that they don’t want, they'll let you know. No matter how hard your board beats on you to make it happen, it won't work. You need to listen to your customers, not just the internal boss."

 

Mr. Schroeder highlighted the importance of focusing on patient satisfaction. "We're still very much wedded to fee-for-service business, but we'll take any quality incentive that people put before us and we will achieve it. We stress the importance of patient engagement and satisfaction to everyone who works at our organization."

 

Dr. Ryan said "The worst thing that can happen in a critical access hospital is that your expenses keep going up. You need to be nimble and partner with other organizations for their services to meet the needs of your community. For example, there's a tertiary care hospital 45 minutes away from my hospital — I partner with them for radiologists."

 

Mr. Grottenthalersaid, "The small to midsize hospitals that are the most successful are the ones sticking their necks out and trying to bring new services to the system. I think if you stand still, you're going to die. You need to continue that innovation."

Mr. Rintoul said small to midsize hospitals in competitive markets must zero in on a specific niche to excel at. "Our physician-owned hospital is located in a very competitive market. While we started out as a general acute care hospital, we had to get more involved in a particular niche to separate ourselves. Find what you can do well and be the best in that area or market, while also stepping back from the things you can't do well."

The community hospital: a dying model or future of healthcare?

Mr. Schroeder said, "Hospital might be a bit too narrow of a focus. We've changed our identity and the way that we operate to a health system. In the future, I think healthcare will stay local. Patients want to get treatment close to home, close to where there family is. So the definition might change, but I think the proximity issue will stay where it's at."

Mr. Schuster said, "A brick and mortar hospital means expense. More and more the population, millenniums and beyond, are going to be looking for the easiest way to get care. They don't want to come to a hospital if they don't have to. As telemedicine progresses, I think the definition of a community hospital is going to change — Is it truly a hospital, or is it just a healthcare provider?"

Mr. Grottenthalersaid he sees a lot of opportunity for small community hospitals to thrive in the future. "Patients need direct access to care. If they have to travel 30 to 50 miles to a larger health system to get it, then they won't do it. It needs to be provided in the community. I think we'll see continued expansion of localized services, bringing more departments and new services to the community."

Mr. Rintoul said, "It really depends a lot on the workforce dynamics — both on the nursing end and also the physician end. If you are in an area where you have a hard time recruiting physicians or nurses, it's going to be very hard to be a successful small hospital."

Dr. Ryan said, "According to the National Rural Health Association, seventy rural hospitals have closed since 2010 and more than 600 are at risk today. There is legislation out there called Save Rural Hospitals that cites quite a few studies that say people actually get better care in a smaller hospital."

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