By Chuck Lauer, Former Publisher of Modern Healthcare
May 29, 2012

Community hospitals are under siege right now. Unlike large medical centers or hospital systems, they do not have the clout to qualify for the highest payor rates or the lowest vendor prices. And these self-standing, non-profit institutions have limited access to financing at a time when we're stuck in economic doldrums.

As a group, these hospitals seem ill-equipped for the vast changes that are sweeping through our industry: the move to expensive healthcare IT, the demands for care-coordination through structures like accountable care organizations and the continuing erosion of Medicare and Medicaid reimbursements.

However, this is not a time to kiss community hospitals good-bye. I don't particularly want to enter a brave new world with just large, impersonal health systems where all of us are just cogs in the wheel. Without these community institutions, there would be a large hole in our healthcare system, and I don't think it could ever be filled.

We've never really agreed on the definition of "community hospital," but for purposes here, I'd like to put the emphasis on "community." An academic medical center can serve an entire region, and a healthcare system can blanket many states, but a community hospital needs to remain firmly anchored to its roots –– the people it serves. Local businesspeople sit on its board, the hospital is the nexus for local healthcare services and the CEO speaks regularly at the Lion's Club.

The community hospital will be relevant as long as healthcare stays local, and I don't think that's going to change anytime soon. In fact, localness and people-power seem more important than ever in what we do. We now talk about "patient-centered care" and hospitals that can align with each physician on staff. A well functioning community hospital commands patient loyalty and binds itself closely to its physicians.

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