Minnesota’s rural hospital crunch: Video chat at 11:30 a.m.

We're hosting a video chat here this morning, following up on the coverage we published last week on the wave of consolidations among rural Minnesota hospitals.

Guests we're planning to have on Google+Hangout:

--Paul Hanson, president of Sanford Health of Northern Minnesota in Bemidji

--Dan Odegaard, chief executive officer of Bigfork Valley hospital in Bigfork, MN

--Jeff Tucker, chief executive officer of Integrity Health Network in Duluth

--Mary Klimp, chief administrative officer at Mayo Clinic Health System New Prague in New Prague, MN

--Terry Hill, executive director of the National Rural Health Resource Center in Duluth.

All are well-versed in the pressures and incentives reshaping health care in outstate Minnesota, so it should be a good conversation. Join us. Meantime, tweet me questions you would ask at @MPRGroundLevel.

Here's a comment we received this morning from Rush City resident Ann Lucas, worrying about the growth of big hospital companies:

If we look back 30 years ago, it was the age of Health Maintenance Organizations. This change in the delivery of healthcare was supposed to reduce costs and for a while it did.

However, along with HMO's came the marketing schemes to draw patients to one healthcare conglomerate or another. Before the advent of managed care organizations, not every hospital had the latest technological gadget. Hospitals often had a cooperative agreement with hospital A sending its patients to Hospital B across town because it did not have the MRI machine and Hospital B sending its patients to Hospital A because it did not have a nuclear medicine department.

The small independent hospital cannot possibly remain competitive when the large monopoly has bought up all the small hospitals around it. Years ago, the small rural hospital knew its limitations and after stabilizing badly injured patients, sent those trauma cases to the large urban hospital with the Level I trauma center.

Just take one look at the billboard advertising and invariably it touts that John Doe Medical Center has the latest in advanced cardiac imaging or cancer treatment or imaging equipment, yada, yada, yada. When you buy a 5-10 million dollar machine you have to justify its purchase and make it cost effective. This means acquiring more patients and more doctors to refer those patients. Voila! The healthcare conglomerate is born.

You do the math.

The basic care at the small rural hospital used to be good enough. They never claimed to be Mayo Health System or Essentia or Catholic Health Initiatives. They provided good, basic medical care. They were an integral part of the community and they were invested in it.

Bigger is not better. Healthcare is becoming increasingly impersonal. The highest rated hospitals for patient satisfaction are usually the small hospitals with 100 beds or less. At that size, the patient is still at the center of care. The patient care loads are smaller and more manageable. You don't feel like inventory on a shelf.

Instead of gobbling up rural hospitals because they can't afford to convert to electronic medical records, we should be finding ways to help them afford what consolidation has put out of their reach---remaining independent and thriving and serving the community.

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