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Rural hospitals partnering with academic surgical departments generated more revenue, boosted patient satisfaction

Partnerships brought in surgeons, helped keep revenue in house by cutting transfers and costs, study showed.

Beth Jones Sanborn, Managing Editor

As rural hospitals struggle to survive, new study from researchers from Texas Tech University Health Sciences-Odessa is making a case for rurals partnering with academic surgery departments as a means to keep surgeons and procedures in-house, reduce patients transfers, increase patient satisfaction and boost revenue.

The study findings were presented at the American College of Surgeons Clinical Congress 2017.

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The research team developed five hospital partnerships between rurals and academic surgery departments, such that each one benefited from the other's resources. Announcements were sent out by local hospitals regarding the partnership pilot program and academic surgeons were placed in rural hospitals. This cut the cost of recruiting and staffing surgeons, and the increased presence of surgeons meant fewer patients had to be transferred to receive services. The partnerships yielded an average net revenue increase of $4.7 million, researchers said.

Academic surgery departments saw benefits too. These departments frequently count on Graduate Medical Education funding to offset the cost of indigent care and education, and the partnerships helped mitigate GME funding cuts.

[Also: Tennessee's Copper Basin Medical Center latest rural hospital to shutter]

A major highlight was that the partnerships boosted patient satisfaction. Because of a dramatic 70 percent drop in patient transfers for participating hospitals, patients were significantly more satisfied with their local service. In fact, patient survey results showed that on a scale of one to 10, average patient satisfaction increased an entire point.

"I'm a big believer that patients shouldn't have to travel very far to get quality care, especially if it's something that can be delivered close to home," said lead author and physician Saju Joseph.

[Also: Rural hospitals continue to struggle to pay for lifesaving drugs]

Additionally, because patients were having their surgical procedures closer to home, family members were more able to visit, which also boosted satisfaction, Joseph said.

A third, and perhaps less obvious benefactor of these partnerships ended up being the state of Texas itself. The decrease in transfers also yielded a projected cost savings for the state of Texas of roughly $7 million.

"The way Texas works is unique because the counties pay for some patient transfers," Dr. Joseph said. "For one small town, saving that money on transfers provided them money to pave their main road. These improvements really show the community that there is something positive going on."

The model program is something that could potentially benefit rural surgery in communities across the U.S. and there is certainly a need. The steady stream of rural hospital closings has been ongoing for several years now thanks to shrinking government funding and low reimbursement rates from government payers, which tend to dominate the payer mix in rural areas, as well as safety-net hospitals. The closings have left gaping holes in access to care for those communities, and could potentially put lives at risk.

A program that increases the quality of hospital staff and can keep surgeons and revenue-generating procedures in-house could well be a boon for needy rurals everywhere who are searching for ways to keep their doors open. Even for those for whom closure isn't an imminent threat, limited or stagnant revenue streams often squelch the possibility of upgrading equipment, like EHRs or medical equipment. This inability to upgrade infrastructure means that a hospital can't upgrade its services, which can damage community confidence, patient satisfaction and ultimately the bottom line.

Twitter: @BethJSanborn
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