What is the best course for rural hospitals to take amid the many changes impacting health care and the hospital industry? There is no one-size-fits-all answer, but experts agree that rural hospitals must make themselves aware of all the challenges they face, and prepare to adapt. Many rural hospitals have affiliated with larger systems or are considering an affiliation. Others are looking to tighten the affiliation they have. Such moves do not guarantee success or even survival, but many industry officials and observers see affiliation as inevitable.

Here are comments from three hospital industry experts on this topic:

todd-reding-executive-cornerTodd Reding, board chair of Grinnell (Iowa) Regional Medical Center: "In 10, 15 years, there will not be independent community hospitals in rural America. The changing conditions of health care require us to be as efficient as possible, providing the highest quality health care that's possible. Independence is inefficient and very expensive."






john-leifer-ecexutive-cornerJohn Leifer, Kansas City-based health care consultant and author:  "Affiliation with a major health system can breathe new life into an otherwise dying facility by infusing capital to improve infrastructure, providing access to a network of high-quality physicians, enhancing clout when purchasing products and services, and tapping into robust IT systems that would otherwise be unaffordable."







nicholas-wolter-ecexutive-cornerNicholas Wolter, M.D., CEO of Billings (Mont.) Clinic:  "Billings Clinic has had an interest in rural health for a long time. We're a fairly large organization by Montana standards — 350 physicians and a 300-bed hospital, and we receive a lot of tertiary care. We manage 11 critical access hospitals. Five of them are joining us in formal governance ways and, in three cases, we've helped communities build new hospitals. It's a real win-win strategy."