In more than 17 years of working as a nurse practitioner in the healthcare system in Langdon, N.D., Gwen Witzel has seen a number of physicians who practiced there for a while, then moved on. 

Until 2011, in order to prescribe medications for her patients, she had to have a collaborative agreement with a physician. 

Many financially struggling rural and independent hospitals have looked to consolidation as a solution, but remaining independent may be a better option for some, argues a Hospitals & Health Networks blog post.

Some rural and community hospitals may choose to retain their independence to keep their healthcare mission locally focused, wrote healthcare consultant Beth A. Nelson of the executive search firm Witt/Keifer. When community providers join larger systems, their vision must refocus, Tim Putnam, president and CEO of Indiana critical access hospital (CAH) Margaret Mary Health, told Nelson.

Read more here! 

Rural and Independent Hospitals: Going It Alone or Teaming Up? 

H&HN Daily, February 5, 2015

There is an unmistakable trend in health care toward partnering and consolidation. Some rural hospitals in particular, however, choose to remain independent - for the good of their patients, staff and community, they argue. It's about preserving the mission, which is a nice notion.

But is there a business case to be made for "going it alone"? Can it remain a viable strategy? If not, is there a degree of creative partnering that affords local facilities independence and control, yet also access to broader services and lower costs?

These are questions that rural and independent hospitals and medical centers are asking themselves almost daily. They are fiercely debated at the annual Rural Health Care Leadership Conference and other gatherings.

The Midwest Affiliate of the American Heart Association has won a grant from a national foundation to implement a system to bring faster treatment for the most serious heart attacks to 88 counties in Iowa.

The system is called "Mission Lifeline," and project director Heather Maier says it involves a high-tech connection between emergency medical personnel in the field and heart specialists in hospitals. "It's a heart monitor that does a 12-lead ECG, and what that does, it looks at the heart from 12 different angles, helping providers determine where the muscle damage  is occurring in the heart during the heart attack," Maier explains.

A bill that would provide permanent funding for at-risk Medicare payment programs that aid rural hospitals across upstate New York has been introduced in Congress.

The bill, co-sponsored by U.S. Sen. Charles E. Schumer, D-N.Y., and Sen. Charles Grassley, R-Iowa, was introduced this week, Mr. Schumer announced Tuesday. It would provide funding needed to continue two programs set to expire in April if no action is taken.

The Low-Volume Hospital Program and Medicare-Dependent Hospital Program collectively have provided 24 rural hospitals statewide with $16 million in fiscal year 2014-15.