Rural hospitals across the country are closing, but a newly formed organization in Southern Arizona is looking to buck that trend.
Tucson Medical Center is expected to announce Monday that it is the hub and founding member of the fledgling not-for-profit Southern Arizona Hospital Alliance, which includes four rural hospitals.
Combined, those rural hospitals serve more than 70,000 people — Benson Hospital in Benson; Mount Graham Regional Medical Center in Safford; Northern Cochise Community Hospital in Willcox and Copper Queen Community Hospital in Bisbee.
Like TMC, rural hospitals in the new partnership want to remain independent, nonprofit and locally governed, a desire that is becoming increasingly difficult as health-care costs rise and larger health systems acquire smaller hospitals, clinics and physician practices.
“We think local health care is best determined by those living in it,” said Jim Dickson, CEO of Copper Queen Community Hospital.
That’s not always possible for smaller hospitals. But by banding together, hospitals in the Southern Arizona Hospital Alliance hope to leverage resources and gain advantages in purchasing, grant-writing and physician recruitment, as well as improved patient access to specialty care and more coordinated clinical care.
“This is a very promising sign that these communities are looking to keep an important part of their community identity while taking advantage of partnering,” said Dr. Daniel Derksen, director of the Arizona Center for Rural Health, which is housed at the University of Arizona’s Mel and Enid Zuckerman College of Public Health. “There is a lot of this going on, and it makes sense.”
Monday’s announcement falls on the same day as a scheduled rally at the U.S. Capitol aimed at preventing more rural hospitals from closing. The National Rural Health Association says that since January 2013, more rural hospitals have closed than in the previous 10 years combined.
“We have the same expenses, but not the same number of patients as a larger institution will have. So volume is the number one thing for rural hospitals that strains us financially,” said Roland Knox, CEO of Northern Cochise Community Hospital.
While there’s no money being exchanged between the hospitals, the hope is that the alliance will bolster the fiscal strength of all the hospitals by improving their operational efficiency. Forming a separate nonprofit organization allows the alliance to apply for grants as one entity, and also do group purchasing.
“We work closely with Tucson Medical Center and the other hospitals in this alliance already, with patient care, staff training and other resources that we all need,” Knox said. “It made sense to formalize those informal agreements. This is an enhancement of relationships we already have.”
Northern Cochise Community Hospital, which serves an area with a population density of 7.5 people per square mile, has been independent since its founding in 1966. Knox says it’s essential for the hospital to have a local board of directors in order ensure the health-care needs of the community it serves are the top priority.
“There’s a lot of pressure, as TMC has experienced. A lot of hospitals have had folks knocking on their door who say, ‘Hey, why don’t you become owned by us?’” said Susan Willis, a TMC executive who is president of the new Southern Arizona Hospital Alliance. “I would say that the independence you see at TMC is even stronger in the rural communities. It’s really important for them to remain independent.”
Benson Hospital CEO Richard Polheber, whose 22-bed hospital is about 48 miles southeast of downtown Tucson, hopes the partnership with TMC will help bring more primary care and specialty doctors to Benson.
“The real challenge we have is recruiting primary care physicians. TMC has a recruiter, and we’re talking to them about helping us,” Polheber said. “Right now people have to go to Tucson or Sierra Vista to see a primary care doctor. The doctors who are here have full practices.”
Polheber said Benson has five primary care physicians, but needs at least four more. The community includes about 12,500 people year-round, but swells to more than 16,000 with winter visitors.
“Getting more cardiology and pulmonology and OB-GYN physicians — we don’t have any OB-GYN,” he said. “I’ve been in rural health care for about 20 years now. People cherish the community they live in, but you struggle to bring in as many of the services as possible.”
The alliance is not intended to freeze out or exclude people from other rural hospitals, Willis stressed.
“We just felt we had to be true to the overall mission, the things we had in common. And that nonprofit and locally governed piece was super strong,” she said.