Utah Rural Independent Hospital Network (Rural 9 Network)

Description

The Utah Rural Independent Hospital Network (doing business as "Rural 9") was established to improve the quality and viability of rural independent hospitals in Utah. The network helps identify and prioritize shared needs related to quality and financial stability, and then implement projects to address those needs. In addition, the network provides communication and networking opportunities, currently at the CEO, CFO, COO, CNO, HR, BO/HIM, IT, and board chair levels, to share common issues, solutions, and best practices.

The network includes all 9 independent, rural hospitals in the state, which serve the 7 counties in which they are located as well as 4 adjacent counties without hospitals. Eight of the network members are Critical Access Hospitals. The CEO of each hospital serves as a representative to the Network's board.

Non-member partners of the network include:

• Utah Office of Primary Care & Rural Health
• Utah Center for Rural Health
• Southern Utah AHEC
• Rural Health Association of Utah
• Utah Hospital Association

Initial development and implementation of the Network was supported through a Rural Health Network Development Planning Grant from the Federal Office of Rural Health Policy. The network's work continues through member and partner support.

The Network's director is currently the Rural Hospital Improvement Director at the Utah Hospital Association and also assists with Utah's Medicare Rural Hospital Flexibility Program (Flex) Coordinator responsibilities in the state. The FLEX Program helps support the network director position via contract with the Utah Hospital Association.

Services offered

Network members work together on projects related to:

• Education, such as department manager training, board training, and revenue cycle and regulatory compliance education
• Purchased services, such as property insurance, supply and maintenance contracts, HCAHPS vendor services, and regulatory compliance assessment/support
• Quality improvement, such as reporting and quality improvement projects
• Business functions, such as revenue cycle improvement and operational efficiency

The network collaborates with the following larger systems to offer these specific services to members:

• ICD-10 preparation (Steward Healthcare)
• Hands-on nurse training (University of Utah)
• Annual rural hospital leadership development conference (Intermountain Healthcare)
• Leadership development workshops (University of Utah)
• Revenue cycle and regulatory compliance training (Intermountain Healthcare)

Members take advantage of cost savings, education, and networking opportunities through group projects and programs, including:

• Common group purchasing organization vendor
• Legal services retainer with a law firm, which includes provision of legal education webinars for members
• Common broker on property insurance
• Human Resource, CNO, BO/HIM, IT, Board Chairs and CEO/CFO/COO groups meet regularly to network, collaborate, and share best practices
• Collaboration with the University of Utah, including rural nurse job shadowing and training, workshop provision, and more
• Department-level manager training
• Regular revenue cycle improvement and regulatory compliance webinars
• Compliance assessment and ongoing support
  
• Collaboration with the state's Flex Program

Results

Some of the major accomplishments of the network to-date are:

• Creation of a legal entity, the Utah Rural Independent Hospital Network, Inc. It operates through a board, bylaws, a strategic plan, a sustainability plan and membership dues.
• Ongoing network sustainability:
  • Members pay a monthly fee of $1,000.
  • Project vendors share savings with network members.
• Collaboration with larger systems in the state provides high quality, low cost services.

Challenges

In Utah, government-owned organizations are not allowed to engage in projects that have the potential to generate profit. Five of network's hospitals are city- or county-owned. The network had planned for certain initiatives, such as mobile MRI, to generate profit that could fund other network initiatives. The solution, found via consulting with a law firm, was for the network to be a Utah Cooperative Non-Profit Corporation.

Another challenge was the relatively small number of participating hospitals, as compared to networks in other states.

The network's participating hospitals have been in an independent mindset for many years. This, at times, makes it a challenge for them to contribute to the collective achievement for all participating hospitals when there is a not a significant gain for their individual hospital.

Replication

The biggest contributor to the success of the network has been the commitment from partner organizations.

The members and partners involved have had long-standing informal relationships that allow members to work together to quickly accomplish their goals.

Another factor in the network's success are the commonalities among member hospitals:

• Similar geographic areas
• Sole providers
• Common missions, visions, and purposes
• Independently owned and operated

Contact Information

Greg Rosenvall, Director
Utah Rural Independent Hospital Network (Rural 9)
Utah Hospital Association
801.793.0426
Greg@utahhospitals.org