IHA Daily Briefing: June 17

Friday, June 17, 2022
Small & Rural Meeting Keynote on Hospital Growth
Gov Regulations, Resources Sessions at Small & Rural
Embracing Extreme Leadership: Small & Rural Session
Illinois COVID-19 Update
Briefly Noted

Small & Rural Meeting Keynote on Hospital Growth
The pandemic has been a game changer in healthcare, straining hospital and healthcare professionals while revealing a system that’s unsustainable and ripe for disruption, said healthcare policy expert Paul Keckley, PhD, in his keynote address yesterday at the IHA Small & Rural Hospitals Annual Meeting in Springfield.

“We need to take a fresh look at where this system is going,” said Keckley, managing editor of The Keckley Report.

In his address, “The Future of Rural Hospitals: Critical Factors for Growth and Sustainability,” Keckley said industry trends and disruption evolve from five zones: clinical, consumer, economic, regulation and technology.

For clinical innovation, he encouraged rural hospital leaders to identify gaps between rural and urban services and consider if integrating health and social services is an option. Examples of transformational clinical innovation include:

  • Hospital to home care;
  • Disease reversal drugs; and
  • Self-care.

In the technology zone, Keckley suggested finding the right technologies to optimize the value proposition of gap-filling services. He also encouraged hospital leaders to continue identifying mechanisms that enable technology access. Examples of transformational technological innovation include:

  • Smart homes and devices;
  • Automation; and
  • Artificial intelligence and decision support.

“Access to technology through new financing vehicles is an opportunity for non-urban health providers,” Keckely said.

Offering context and a strategic perspective on rural health, Keckley cited statistics from the Centers for Disease Control and Prevention showing Americans who live in rural areas are more likely than urban dwellers to die prematurely from all five leading causes of death: heart disease, cancer, unintentional injury, chronic lower respiratory disease and stroke. Health behaviors, healthcare access, healthy food access and demographic characteristics are contributing factors.

“I don’t think the world you live in is an easy world,” Keckley said, challenging attendees to monitor innovation happening outside of hospitals and healthcare so that hospital leaders “get a sense of what is being used in other industries that can be used in this industry.”

See Keckley’s slide presentation and follow us on Twitter for more about the annual meeting.


Gov Regulations, Resources Sessions at Small & Rural
Two sessions at today’s IHA Small & Rural Hospitals Annual Meeting explored the impact of the federal government on hospitals—from managing regulations to leveraging resources from the Health Resources and Services Administration (HRSA).

In “Federal Regulatory Update: Impact on Rural Providers,” Martie Ross, JD, of the consulting firm PYA, covered the annual rulemaking process of the Centers for Medicare & Medicaid Services (CMS), the Rural Emergency Hospital program, price transparency and the end of the public health emergency.

Ross walked through negotiated rate data reported by hospitals under Hospital Price Transparency requirements, imploring Illinois hospitals to take charge of the price transparency narrative and tell their stories.

While discussing CMS’ annual rulemaking process, Ross highlighted that health equity is part of every CMS proposed rule. She also said it’s likely CMS will tie payments to equity measures in the future.

“It is very important as we move forward with health equity that we understand where these inequities live,” said Ross, director of the Center for Rural Health Advancement. “Let’s start looking at data, collecting data and analyzing data, so it tells us where these disparities are.”

On the REH program, Ross noted:

  • CMS must begin paying for services by Jan. 1, 2023;
  • Implementing regulations are not final yet—the proposed rule is awaiting approval from the Office of Management and Budget; and
  • Payment for services will be 105% of the applicable Outpatient Prospective Payment System rate.

The second session, “HRSA Resources to Support Rural Hospitals,” showcased how HRSA supports rural hospitals through grants and technical assistance. HRSA also has targeted programs to help address workforce needs in rural healthcare. These include:

  • National Health Service Corps and Nurse Corps to support primary care and mental health providers, with 6,000 individuals serving rural communities nationwide;
  • Teaching Health Center Graduate Medical Education Program that trains in community-based outpatient settings, with 93% getting their training in medically underserved or rural communities; and
  • Behavioral Health Workforce Development Programs to enhance training for professionals and paraprofessionals, with 52% gaining experience in treating substance use disorders.

Tom Morris, MPA, associate administrator of rural health policy with HRSA, led the session. Morris oversees the Federal Office of Rural Health Policy, which advises the secretary of the U.S. Dept. of Health and Human Services on rural health issues.

“We [at HRSA] are about policy and regulation, we focus on relationships and capacity building,” he said.

Discussing the ongoing implementation of the Medicare Graduate Medical Education changes, Morris stressed the importance of this program, saying it will put residents in the community, critical because “we know you are more likely to practice where you trained.”

See Ross’ slide presentation and Morris’ slide presentation. Follow us on Twitter for more about the annual meeting.


Embracing Extreme Leadership: Small & Rural Session
What does it take to embrace extreme leadership? First, start with a leadership funeral. Then, commit to radical transparency, be tough on results but tender on people, keep your eyes on and hands off, and—importantly—champion the culture.

In a riveting closing session at this year’s Small & Rural Hospitals Annual Meeting today, ultra-endurance competitor Urs Koenig, PhD, MBA, MS, PCC, shared his vision of extreme leadership and the steps needed to achieve it.

“We cannot rely on the same old model of leading our teams and expect good outcomes. We need fresh, new ideas,” he said. “Let go of outdated leadership and embrace new, more relevant knowledge.”

Koenig was a successful skiing competitor and coach; a record-breaking ultra-endurance athlete in cycling and adventure racing; and a military peacekeeping commander for NATO at age 50. In his session, “Extreme Leadership for High-Performing Teams,” Koenig encouraged hospital leaders to create a “stop doing” list as part of their leadership funeral, putting to rest leadership behaviors that do not motivate teams or produce results.

Leading with “radical transparency” translates to higher trust and higher accountability, Koenig said. Ensuring your team members are informed empower them to make good, smart decisions.

“To turn our teams into high-performing units we need to drive, build and own the culture,” he said. “The most important thing we can do is provide a culture of psychological safety where people feel safe to ask questions, raise concerns and raise doubts without fear.”

““It’s more important how the team works together, than who is on the team,” he added.

See Koenig’s slide presentation and follow us on Twitter for more about the annual meeting.


Illinois COVID-19 Update
The Illinois Dept. of Public Health (IDPH) today reported 3,499 new confirmed and probable COVID-19 cases, and 15 COVID-19 deaths.

Most recent IDPH hospitalization data show 1,162 individuals in Illinois were reported to be in the hospital with COVID-19. Of those, 131 patients were in the ICU and 33 patients were on ventilators.

The seven-day rolling average of vaccines administered daily in Illinois is 9,891 doses. IDPH reported that 78% of Illinoisans (18 years and older) have been fully vaccinated, while 86.2% have received at least one vaccination dose. For the Illinois population 12 years and older, 76.8% have been fully vaccinated, while 84.9% have received at least one vaccination dose. For the Illinois population 5 years and older, 73.3% have been fully vaccinated and 81.1% have received at least one dose.

Today, the Food and Drug Administration (FDA) recommended emergency use of the Moderna COVID-19 vaccine for children between 6 months and 17 years of age. The Moderna vaccine had been previously authorized for adults 18 years and older. The FDA also authorized emergency use of Pfizer’s vaccine for children between 6 months and 4 years of age. The Pfizer vaccine had been authorized for use in individuals 5 years and older.


Briefly Noted
A new study published in Current Psychiatry Reports that undertook a “wholistic review of research on youth substance use” during COVID, suggests “the prevalence of youth substance use has largely declined during the pandemic.” The research abstract emphasized that adolescence is an “important developmental stage during which the foundation for future patterns in substance use is often established,” and noted that post-pandemic substance use in this population “will require monitoring and continued surveillance.”

Only 12% of physicians practiced in rural areas in 2021, yet 20% of the U.S. population resides in rural areas. Tune in for a podcast discussion focused on the unique challenges rural residents face in accessing quality health care and Health Resources and Services Administration (HRSA) programs that are working to increase health equity and access in rural communities. Hosted by Tom Morris, Associate Administrator of HRSA’s Federal Office of Rural Health Policy and Jessica Nicholson, senior economist at The Conference Board’s Committee for Economic Development, the free podcast is available here.