As in the old barn-raising tradition, rural health systems are being built by communities, rather than by single institutions.
For example, it is taking a hospital system, nursing home, university and other local organizations to structure a hearty healthcare delivery system in rural northwest Ohio.
The lead provider involved is Blanchard Valley Health Association, which includes a 150-bed hospital in Findlay, Ohio; a second, 42-bed hospital outlying the town; six medical offices; and related businesses, such as an independent-living center, a hospice and a home health agency.
Despite its already significant diversification, Blanchard Valley must expand further to buttress its bottom line against changes in reimbursement and competition, said William Ruse, its president and chief executive officer.
Ruse will describe Blanchard Valley's efforts in two ACHE congress sessions, "Developing Rural Integrated Healthcare Delivery Systems." The sessions are scheduled for 4 p.m. to 5: 30 p.m. Monday, March 3, and 8: 30 a.m. to 10 a.m. Tuesday, March 4.
Findlay, population 38,000, some 47 miles south of Toledo, has a decidedly rural flavor. Outside the city boundaries, the landscape turns immediately into fields of corn, soybeans and wheat.
"The rural environment will develop differently than the urban setting, where the number of providers are decreasing," Ruse says. "In the rural area, communities want to hold onto their institutions so badly, you're going to have to assimilate. Our policy is to try to use our resources to partner with others."
Because so many large groups have gotten the traditional aspects of healthcare in hand, smaller systems must differentiate themselves to survive independently, he says.
Blanchard Valley plans to become an occupational health expert in partnership with the University of Findlay. The university, a private institution, developed a strong program in hazardous materials management because a local company cleans up toxic waste spills.
Occupational medicine is a related discipline often taught in tandem with hazardous materials management, Ruse says. When the university completes a new clinic later this year, the hospital in Findlay, Blanchard Valley Regional Health Center, will move half its rehabilitation cases to the site, Ruse says. Eventually, students will be able to obtain a bachelor's degree in hazardous-materials management and a master's degree in occupational medicine.
The long-run hope is that the hospital will become involved in launching occupational health clinics abroad, as foreign students graduate from either program and return home, Ruse says.
What's more, a joint training program for physician assistants, developed by the hospital and university, is set to start in September 1998.
The Blanchard Valley system also is working on partnerships with a local mental health clinic and a nursing home to round out its delivery system.