GRAND FORKS — An organization dedicated to supporting independent hospitals in small towns has helped facilities in North Dakota and Minnesota form their own rural health networks.Personal experience in the field and the changing landscape of health care are what drive the team at Cibolo Rural Health Networks.
Cibolo President and CEO Nathan White said the organization is committed to helping small-town hospitals stay open and maintain their independence.
“How do we help these rural hospitals not just survive but thrive?” he said. “I think that's the fundamental question that really energizes us. And it's also really positive to see the energy of hospitals for new opportunities. That's why we're doing this.”
Cibolo works with independent, rural hospitals to create Healthcare Integration Networks, groups of health care providers that work together to improve quality and reduce costs. Cibolo has built two networks so far: the Rough Rider High Value Network in North Dakota, which has 23 hospitals and 41 clinics working together, and the Headwaters Network in Minnesota, which has more than 50 clinics and 19 hospitals working together, but the latter is one it expects to grow.
These networks work with insurers and have value-based care contracts, but Clint McKinney, Cibolo's chief medical officer, said this is different from what's prevalent nationwide: Many providers are paid based on the amount of services they provide, even if they don't help patients, and McKinney said he doesn't like that.
“It might sound a little cynical, and it might be, but I would say to people that as a doctor, I get paid more regardless of whether what I do for you, the patient, helps or doesn't help,” he said. “And I think that's fundamentally wrong, if not morally wrong.”
Value-based care, by contrast, rewards doctors and hospitals for continually improving the quality of care and services they provide to patients and for the responsible use of health care funds, he said.
Cibolo was born with the creation of the Rough Riders network. Three and a half years ago, hospital CEOs from around the state got together and started talking about how they could work together to share best practices and resources, improve clinical performance and make investments to realize those goals. White says this was new territory and the group wasn't sure what the collaboration would look like. Months before Rough Riders and Cibolo officially formed, there were multiple conversations with the CEOs about what was important to them and how the group should be structured. The hospitals' main goal was to remain independent. Some hospitals around the state have had to partner with large health systems to survive, and that wasn't the direction Rough Riders wanted to go.
“The watchword was 'independence through interdependence,'” White said.
White said Cibolo was set up as a combination consulting and management company to help Roughrider members think about how to build and operate their networks. CEOs of rural independent hospitals in Minnesota took notice and reached out, most recently forming Headwaters. White said Cibolo's goal now is to prove that these network concepts work and improve the communities they serve from a health care perspective.
McKinney added that Cibolo is committed to the “Triple Aim,” a term often used in health care that refers to the three main objectives a health care system should have: improving patient care, improving the health of the community and using resources wisely.
“And that's what we want to achieve,” he said.
Otto is a community reporter for the Grand Forks Herald.
