Description

The Indiana Statewide Rural Health Network (InSRHN) is a network that was established in 2007 with the mission of supporting rural healthcare organizations as they coordinate services, improve and expand healthcare access, and enhance healthcare delivery for member hospitals and their communities.

Totaling 24 Critical Access Hospital (CAH) and rural hospital members, InSRHN has maintained financial stability and has grown the corporation by offering fee-for-service technical assistance programs to benefit network members.

InSRHN member hospitals achieve improved operations and services through the networking activities made available to them, including technical resources, information technology, support services, and network business opportunities (group purchasing, email hosting/web design, board education, leadership support, peer review services, remote pharmacy services, and shared services programs).

Roundtables, or peer discussion groups, influence future planning for the network. These statewide meetings, held most often via videoconferencing, offer a chance for peers from member hospitals to collaborate and discuss efficiencies of operations, improvement, obstacles, best practices, trends, and any other topics that may arise.

Working through the Indiana Rural Health Association (IRHA), initial funding for InSRHN came from a 2007 FORHP Rural Health Network Development Planning grant and a subsequent 2008-2011 FORHP Rural Health Network Development grant. Today, network sustainability comes primarily through annual membership dues, with a small portion of revenue coming from a revenue stream from shared savings.

Services offered

• Offer Community Health Needs Assessments (CHNAs) at a substantial discount to members
• Develop a network of trusted partners among stakeholders with interest in rural health
• Provide infrastructure for building relationships among rural hospitals
• Facilitate the sharing of knowledge and resources
• Assist with reducing the feelings of geographic isolation faced by rural hospital administration and staff
• Help identify and eliminate unneeded duplicative services and technology within the network
• Identify and promote rural-appropriate best practices
• Utilize InSRHN staff to access state resources and other funding sources
• Host CEO forums, job postings, and other pertinent information on rural network website
• Assist with physician and general healthcare workforce recruitment, including toolkits for human resource departments
• Partner with other leading healthcare organizations, including the Medical Group Management Association (MGMA) and the Healthcare Financial Management Association (HFMA), to better serve members

Results

InSRHN achievements include:

• Network expansion to include 24 rural healthcare facilities
• Executive Peer Discussion Groups
• Establishment of a pilot program with the Indiana State Museum (including 11 remote sites in the state) to bring awareness and education to rural communities regarding substance use disorder
• Expansion of the InSRHN Contract Portfolio, providing members substantial savings

General program results include:

• InSRHN telehealth projects are increasing availability and quality of services to underserved populations, thereby showing an improvement in health outcomes for rural Indiana patients.
• Videoconferencing, roundtables, and leveraging of group resources have all shown successful results regarding networking, efficiencies, problem-solving, improvement of services, time savings, and cost savings with the ultimate goal of hospital performance improvement.

Challenges

While the member organizations certainly valued the networking component of InSRHN early on, members also wanted to see financial value of their participation in the network if they were going to pay annual membership dues. Leveraging group buying power and coordinating services brought in that financial value to network members.

Determining the revenue stream post-grant funding was a challenge. However, since its launch, InSRHN has continued to add members and now offers a discounted rate for healthcare "systems." Furthermore, some InSRHN facilities embarked on the National Rural ACO (Accountable Care Organization) model with efforts supported by InSRHN staff.

Replication

Both "Bottom Up" and "Top Down" approaches are utilized when securing buy-in. CEOs must have buy-in from their frontline employees, but those employees must also have buy-in from their CEOs.

InSRHN follows a rough plan for all projects implemented:

• Needs assessment
• Interest and participation surveys/discussions
• Signed Memoranda of Understanding by interested members
• Project planning
• Evaluation and selection of vendor, service, and partner
• Business plan
• Project management implementation (be flexible, but goal-oriented)
• Satisfaction follow-up
• Data collection and program evaluation

Contact Information

Phil Ellis, Network Director
Indiana Statewide Rural Health Network
317.902.1749
pellis@indianarha.org