Session and Event Descriptions

SUNDAY, FEBRUARY 4th

12:00 - 5:00 pm
CONFERENCE REGISTRATION

2:00 - 3:30 pm
WORKSHOP #1: Engaging Governing Boards and Leadership in Embracing Accountable Care Challenges
Lynn Barr, CEO, Caravan Health

Rural hospital leaders are challenged with navigating the shaky bridge from fee-for-service and cost based payment models to value based accountable care models. A key aspect is engaging boards of trustees in support for the transformation journey. In rural communities, board members often wear many hats and are stretched thin, making the prospect of engaging them in the move into accountable care models a significant task. CMS requirements, time-frames, and planning time needed to participate in accountable care payment models make a board education strategy eminently important. This workshop will provide a pathway for rural hospitals leaders to engage with their boards to prepare them to support the formulation and implementation of plans to move their rural facilities into accountable care models. You'll learn about a board education model that was developed from the experience of convening 23 rural ACOs that include 164 rural hospitals. Participants will gain an understanding of how MACRA impacts rural hospitals and clinics, the requirements for Quality Payment Program (QPP) reporting for hospital and non-hospital-based providers, and how to communicate this effectively to the board. Engaging your board around the basic components of a sound population health model will pave the way to accountable care.

2:00 - 3:30 pm
WORKSHOP #2: Creating a Cultural Blueprint to Engage Employees, Clinicians and the Rural Community
Joe Tye, CEO and Head Coach, Values Coach Inc., and Ryan Smith, Chief Executive Officer, Memorial Hospital of Converse County

This workshop offers participants new insights into how to assess the effectiveness of their organization's statement of values, as well as ideas for optimizing its use to shape culture and recruit staff. You'll learn tactics for earning employee and clinician engagement in a Culture of Ownership, and for defining the role of the board in monitoring that culture. Explore how one rural hospital transformed a generic and meaningless statement of values into a robust Cultural Blueprint including how the hospital engaged employees, clinicians, board members and the community at large in a dialogue about core values. You'll see how that blueprint guides hospital leadership through difficult decisions such as balancing compassion and the law when dealing with an employee diverting medications or taking a stand on public policy measures that are best for the organization but at variance with dominant community opinions. Finally, the presenters will offer ideas for assessing the ROI for work on culture, including the impact on employee turnover, organizational productivity, quality and safety, and community reputation.

 

MONDAY, FEBRUARY 5th

7:00 - 8:00 am
CONFERENCE REGISTRATION & CONTINENTAL BREAKFAST

8:00 - 8:20 am
CONFERENCE WELCOME
Presentation of the 2017 AHA Rural Hospital Leadership Award

8:20 - 9:30 am
GENERAL SESSION
True Success: The Art of Achievement in Times of Change
Tom Morris, PhD, American Philosopher, Chairman, Morris Institute for Human Values, and Best-Selling Author

While the ancient world had Socrates, for new millennium problem-solving, we have Tom Morris, one of the most pioneering public philosophers of our time. Morris brings the wisdom of the greatest philosophers of the ages to bear on the challenges of today, helping audiences to live and work better and smarter. We all need ideas that we can trust to help us achieve success in demanding situations. In this entertaining opener, Morris presents a simple yet powerful framework of seven universal conditions for achieving sustainable excellence.

9:45 - 11:00 am
GENERAL SESSION
Reimagining Future States of Rural Health Care
This panel draws on the work of the AHA Committee on Health Strategy & Innovation to explore future health care delivery models in rural communities that expand access, improve health outcomes and lower the total cost of care. Panelists will also highlight how strategic collaborations and key stakeholder relationships can be integrated to strengthen the models and drive success.

11:15 am - 12:30 pm
STRATEGY SESSIONS

#1 Finding a Medical Home for Superutilizers
Jason Spring, Chief Strategy Officer, Kalispell Regional Healthcare and Phillip Pandolph, CEO, Meadville Medical Center

Managing care for medically and socially complex patients or superutilizers is clinically challenging and resource intensive. Using transitional models hospitals can improve the health and well-being of patients frequenting the system by coordinating their care, and conserve scarce resources by analyzing admissions, managing utilization of the ER and coordinating community assets including housing, transportation, food and other safety-net resources. This session examines approaches in transitional care from two rural organizations.

#2 Extending Health Care Delivery through Telemedicine: The Virtual Hospital Experience
Kayleen Lee, CEO, Sioux Center Health; Bryan Slaba, MHA, FACHE, CEO, Wagner Community Memorial Hospital - Avera; and Darcy Litzen, Client Development Officer, Avera eCARE

Telemedicine is opening up a new way for consumers to access health care and for facilities to receive support in every aspect of the patient care continuum. This session explores how a virtual health system model is transforming care delivery through technology, collaboration and innovative solutions, and extending care, including specialty visits, emergency care and ICU services, to some of the most rural and remote communities in the U.S. Learn how Avera eCARE's extensive history of service translates to measurable outcomes with lives saved, improved patient care and cost-effective care in underserved communities. Leaders from two rural hospitals will describe the key processes and challenges of serving remote communities, addressing change management practices to build a successful virtual hospital program.

#3 Developing a Behavioral Health Care Service Line at a Small Rural Hospital
Michael Glenn, CEO, Jefferson Healthcare; Joe Mattern, MD, CMO, Jefferson Healthcare; and Sue Erlich, MD, Medical Director, Discovery Behavioral Healthcare

Jefferson Healthcare's behavioral health services service line, which offers meaningful integration of behavioral health and primary care, partnerships with local mental health and substance abuse providers, an ED equipped with safe, treatment rooms and a safe, secure and code compliant inpatient room, and activated tele-psych services for 24/7 access to psychiatric consultation, is improving quality, safety and access to care. Leaders will describe the the critical elements of a rural behavioral health care service line, financial strategies to achieve integration, cost effective methods to establish compliant inpatient crisis and stabilization services, and approaches to partner successfully with local providers.

#4 Collaborative Governance and Staffing Practices that Lead to Rural Health Success
Robin Schluter, President/CEO, Regional Health Services of Howard County; George Willis, Chair, Board of Trustees, Regional Health Services of Howard County; and Shelly Russell, CEO, Mitchell County Regional Health Center

This session will share the experiences of two CAHs that have achieved greater financial success, improved staff recruitment, and expanded patient services through CEO driven and local board endorsed collaborative practices. You'll learn how the two community boards approached collaboration and what considerations came into play to transition the board mind set to the new strategy. The presenters also will explore how sharing highly skilled and hard to recruit staff has enabled both organizations to fill roles and recruit candidates that normally would not look at a single CAH role—with the added benefit of enhancing mentoring and succession planning. Understand what collaborations have had the biggest impact on patient services and what comes next for these two CAHs that have embraced the benefits of working together.

12:30 - 2:00 pm
Networking Lunch with Hot Topic Roundtable Discussions

2:00 - 3:15 pm
GENERAL SESSION
Health Care is not Enough
Jason Purnell, Assistant Professor, George Warren Brown School of Social Work, Washington University

The United States spends 18% of GDP on medical care, but its health outcomes lag those of its wealthy peers. Public health and medical researchers have long known that health care only contributes to 10-20% of health outcomes like disease, disability, and premature death. Far more powerful are lifestyle behaviors (e.g., smoking, physical activity, and health diets) and the social and economic conditions that shape them (e.g., education, income, and wealth). Communicating the importance of what are called the social determinants of health and advancing policies and practices to address them has been a central focus of Jason Purnell's applied research agenda. Learn about this crucial area of work in order to advance the health of individual communities and the nation as a whole.

3:30 - 4:45 pm
MORNING STRATEGY SESSIONS #1-#3 REPEATED WITH NEW SESSION #4

#4 CEO Succession Planning - Your "Must Do's"
Bill Westwood, Senior Client Partner, Korn Ferry and Tom Giella, Chair, Health Care Services, Korn Ferry

Examine the best practices of CEO succession planning in a health care setting. The session will include a thorough description of the process to follow to ensure that succession planning is smooth, efficient and objective. It also will include specific recommendations for the roles that each party plays in the process, and what risks should be avoided. Board members, incumbent CEO's and potential CEO's will learn how to prepare for and execute succession planning in their organizations.

5:30 - 7:00 pm
NETWORKING RECEPTION

TUESDAY, FEBRUARY 6th

6:45 - 8:00 am
CONTINENTAL BREAKFAST

7:00 - 8:00 am
SUNRISE SESSIONS

#1 Hospitals Against Violence: The Impact of Community and Workplace Violence in Rural Health Care Settings
Join AHA rural hospital members as they discuss their challenges and successes in addressing workplace and community violence issues. This session is part of an ongoing series related to the AHA's Hospitals Against Violence (HAV) initiative, which started in September 2016 at the direction of the AHA Board. The goal of this session is to engage in dialogue with leaders who are working proactively to break cycles of violence in their organizations and communities that impact the workforce and their ability to provide safe patient care.

#2 Governing Under Changing Rules
Paul Maughan, PhD, Commissioner and President of the Board, Island Hospital

Learn how the governing board of a Medicare-dependent rural hospital is preparing for change to ensure that consistent quality health care is provided to the communities it serves in an ethical, cost-effective manner, so that individuals can achieve their optimal level of wellness. Commissioners govern by establishing policies, making strategic decisions and overseeing the organization's activities. When faced with changing rules, the board should seek information from multiple sources including drawing assistance from the community as well as other resources. Join this discussion to examine best practices for how governing boards can effectively collect and consolidate information in order to formulate and implement strategic policies to ensure the mission is achieved.

8:15 - 9:30 am
GENERAL SESSION
The Rural Hospital Federal Update
Sarah Macchiarola, Senior Associate Director, American Hospital Association and Priya Bathija, Senior Associate Director, Policy, American Hospital Association

This session will provide a federal regulatory update on recent regulations impacting Critical Access Hospitals and rural PPS hospitals. Learn what policies Congress is considering and what it means for rural community hospitals.

9:45 - 11:00 am
STRATEGY SESSIONS

#1 A Rural Health System Tackles the Opioid Crisis
Lee Boyles, President and CEO, CHI St. Gabriel's Health; Kurt DeVine, MD; and Heather Bell, MD

At CHI St. Gabriel's Health, recipient of the 2017 AHA NOVA Award, a clinic-based, multi-disciplinary team works toward reducing narcotic and opioid use through care plans and patient visits. A community task force works to change opioid prescribing practices, to monitor use and to reach all opioid-using patients. Collaborative partners with the hospital and its family medical center include public health, sheriff's office, police department, long-term care facilities and prevention groups, and local-medical assistance provider South Country Health Alliance. Learn how this award-winning rural health system is mobilizing its community to tackle the opioid crisis.

#2 Critical Access Hospital R&D - Investing in Value-Based Care Capacity
Clint MacKinney, Clinical Associate Professor, University of Iowa; Jennifer Lundblad, President and CEO, Stratis Health, Bloomington, MN; Ed Pitchford, President and CEO, Cole Memorial Hospital; and David Crandall, Board Member, Cole Memorial Hospital

The critical access hospital's capacity to deliver better care, improved health, and smarter spending (or health care value) requires research and development investment. But how does a CAH determine how much and where to spend R&D funds? This session will introduce the concept of health care value, describe why value remains important during times of uncertainty, and discuss how to start a value conversation with the board. This conversation with CEOs and trustees from innovative rural hospitals will probe their successes and challenges balancing investment in operational improvement and investment in value-based R&D. Participants will be able to identify value-based care success factors among CAHs, understand how to build infrastructure and capacity for value-based care, and hear how challenges and barriers have been addressed.

#3 Accountable Health Communities: Addressing the Impact of the Social Determinants of Health
Laural Ruggles, Director, Community Health Improvement, Northeastern Vermont Regional Hospital; Paul Bengtson, CEO, Northeastern Vermont Regional Hospital; and Billie Lynn Allard, MS, RN, Administrative Director of Ambulatory Care and Transitions of Care, Southwestern Vermont Health Care. Moderated by Priya Bathija, Senior Associate Director, Policy, American Hospital Association

Recognition of the impact of social determinants of health on outcomes of care is pivotal to the creation of an Accountable Health Community in which appropriate utilization of resources is maximized and individuals engage in healthier living to meet their goals for the future. Learn how rural hospitals can bring key decision makers from diverse partner organizations such as FQHCs, mental health, housing, community action, and charitable food to the table around common goals and measures to improve health in the region. Using the medical home foundation of primary care and the retooling of acute care clinicians based on community needs, providers can meet the goals of the quadruple aim. This session offers replicable strategies to turn the curve on population health measures.

#4 Rural Health Care Transformation through Collaboration
Steven Tenhouse, CEO, Kirby Medical Center; Harry Brockus, CEO, Carle Hoopeston Regional Health Center; and Chirag Patel, Executive Director, Carle Foundation Hospital

The Carle Health System's Rural Alliance for Exceptional Care seeks to improve quality and access to health care while keeping care local in the rural communities. This session examines the different journeys of the relationship and joint services provided between a tertiary health care system with a clinical affiliate CAH compared to a fully integrated CAH. You will learn why a vertically integrated health system would support creating a new model of care for rural communities and examine the forms of collaboration transforming care with elements such as clinical support, medical and board leadership, shared EMR and quality. Understand how strategic goals are met for providers through different partnership models and examine the positive impact on outcomes throughout the care continuum.

11:15 am - 12:30 pm
STRATEGY SESSIONS #1-#3 REPEATED WITH NEW SESSION #4

#4 Collaboration across the Continuum Supports a Focus on the Consumer
Linda Thorpe, Chief Executive Officer, East Morgan County Hospital and Linda Roan, RN, Chief Nursing Officer, East Morgan County Hospital

At East Morgan County Hospital a focus on the consumer is changing a culture of acute care to one of greater collaboration and care management in which integration of acute care, emergency medicine, rural clinics and specialty clinics is leading to improved and consistent care to the community. Learn how broad collaboration with community, tertiary care and internal resources has supported a successful Women's and Infant Services Service line in a critical access setting. Understand how embedded physician leadership and services in local long term care facilities increases physician access to a vulnerable and fragile population leading to improved outcomes. And explore how balanced use of Advanced Practice Providers and physicians support the community need and provide an expanded availability to the consumer.

12:30 - 1:30 pm
NETWORKING LUNCH

1:30 - 2:45 pm
GENERAL SESSION
Decisions, Decisions: Trends and Effective Leadership and Governance of Rural Hospitals
Jamie Orlikoff, President, Orlikoff and Associates, Inc.

Health care is in turmoil, and nowhere is the impact of that more apparent than for the canaries in the coal mines of U.S. health care: rural hospitals and health systems. This session examines the challenging and conflicting trends buffeting U.S. health care, and unpacks their implications. Jamie Orlikoff outlines strategies for boards and leaders to maximize the effectiveness of their decision-making to help their organizations survive this risky time.

3:00 - 4:00 pm
BUSINESS BRIEFING
Restoring Rural Health Care Services through Regional Hospital Partnerships
Jared Florence, VP, Business Development, Deaconess Health System; Alisa Coleman, President & CEO, Ferrell Hospital; and Alan Richman President & CEO, InnoVative Capital LLC

Learn how two CAHs worked with a regional health system to develop a new comprehensive health care campus with a rural health clinic, diagnostic and lab services along with an extended hours walk-in clinic tailored to meet the needs of the community. Examine the financial and physician care hurdles facing most rural hospitals including the challenges in developing a tri-hospital operating agreement and negotiating the financial and operational responsibilities between all parties. Learn how the joint venture organization worked with its financial advisor to develop its business plan, financial pro forma, hospital and county board approvals and apply for a USDA loan to finance the facility project.

3:30 pm and on
Optional Recreational Activities
Stretch your legs with a hike across the desert or explore the Southwest through art, food and shopping.

WEDNESDAY, FEBRUARY 7th

7:00 - 8:45 am
CONTINENTAL BREAKFAST

7:30 - 8:45 am
STRATEGY SESSIONS

#1 Reducing Hidden Costs and Improving Effectiveness in a Rural Medical Center
Dave Dobosenski, MBA, CEO/President, St. Croix Regional Medical Center; John Conbere, MDiv, EdD, Co-Director, SEAM Institute; and Alla Heorhiadi, PhD, EdD, Co-Director, SEAM Institute

Health care systems are seeking ways to improve their cost-effectiveness, employee engagement, and patient care. Frequently they try short term fixes, only to find that a year later, not much has changed. This session presents a case of the St. Croix Regional Medical Center, which invested in a long-term systemic change intervention that led to increased engagement, improved morale, sustainable culture change, and reduced hidden costs. Learn how St. Croix used Socio-Economic Approach to Management (SEAM) to address both the people side of the organization as well as the financial side to identify and reduce hidden costs, and subsequently reinvested the savings to support innovation and develop employee potential.

#2 Population Health as a Winning Strategy for Rural Community Hospitals
Lee McCall, CEO, Neshoba County General Hospital and Don Wee, CEO, Tri-State Memorial Hospital

Merit-based Incentive Payment System Alternative Payment Models that utilize population health strategies can result in decreased inpatient costs for patients, but bring significant opportunities for expanded market share and an increase in overall health system revenue through new preventative screenings and wellness services. This session demonstrates how rural hospitals engaged in the Magnolia Evergreen Accountable Care Organization, a Medicare Shared Savings Program Track 1 (MIPS) ACO, increased revenue by 7% and increased the quality of patient care and reduced overall Medicare spend by more than 8%. Learn about key programing for a successful, sustainable value-based model—including billable care coordination programs, HCC coding/documentation, behavioral health integration, clinical improvement activities, practice workflow redesign—in order to better manage population health and navigate value based reimbursement.

#3 Cultivating Nurse Engagement through Shared Governance
Bobbi Hallberg, Chief Nursing Officer, Willapa Harbor Hospital and Linda McClarigan, CNO & VP, Patient Care Services, Adirondack Health

At the center of any organization that hopes to be successful in achieving the triple aim plus one is an engaged nursing staff. The challenge has been how to keep nurses in the rapid-fire, tumultuous health care environment from burning out. One method of achieving engagement is through the implementation of Shared Governance. This session will focus on the critical processes necessary for building a robust Shared Governance team in rural hospitals and clinics. We'll delve into practical strategies to ensure success and methods to promote sustainability. Learn how implementing Shared Governance, even in a small rural setting, with limited resources and a challenging union environment, has created partnerships and built bridges between staff nurses from across the continuum with nursing leadership that re-ignited and engaged the workforce to achieve excellence everyday for patients and staff.

#4 The Board Chair: The Role, Responsibilities and Performance Evaluation
James E. Orlikoff, President, Orlikoff & Associates, Inc.

A simple truth of governance is that a significant part of a board's effectiveness depends upon the quality of the board chair. No individual board member has more influence on board culture and performance than the board chair. By clearly defining the chair's position, role and responsibilities, and authority, a board helps ensure that it governs based on principle and policy, instead of personality. Effective boards also strive to oversee their chairs; while ineffective boards are controlled by them. Periodically assessing board chair performance can make a good chair even better. This presentation outlines key approaches to clarify an explicit role and job description for the board chair and offers a step-by-step process for establishing a productive board chair evaluation process.

9:00 - 10:15 amSTRATEGY SESSIONS #1 and #2 REPEATED, WITH NEW SESSIONS #3 and #4

#3 Rural Recruitment and Retention Playbook: Practical Ways to Attract and Keep Physicians
Glen Frick, Chief Operating Officer, UMC Physicians; Paul Acreman, Medical Group Healthcare Consultant, UMC Physicians (retired); Neal Waters, Regional Vice President, Recruiting, Jackson Physician Search

For rural hospitals and clinics, delivering on the promise of a rewarding clinical practice and balanced lifestyle seems like an insurmountable challenge. Concepts like transparency, autonomy, engagement and sustainability are just buzzwords without the operational structure and commitment to support them. For organizations delivering care in rural communities, the answer is to develop and implement the right operational policies and practices that start with recruitment and extend well beyond start-up. They provide the practice support—and create the culture—that focus on taking care of the doctor. This session will explore how concepts like transparency, autonomy, engagement and sustainability translate into actionable tactics that support physicians in their rural practice, and in turn, increase the success of recruiting new doctors and families to their communities.

#4 Interactive Governance Clinic
James E. Orlikoff, President, Orlikoff & Associates, Inc.

Bring your thorniest governance issues to one of the nation's preeminent health care governance experts. You'll gain practical solutions and proactive ideas for improving governance performance. This session will be very interactive and no issue is off the table, so come prepared to talk, to question and be challenged!

10:30 - 11:45 am
GENERAL SESSION
Resilience and Well-being: A Path Forward
Thomas Jenike, MD, Chief Human Experience Officer and Senior Vice President, Novant Health and Nicholas Beamon, One Team Leadership

Today's physicians are expected to deliver world-class clinical care and at the same time keep up with the economic, technological, regulatory, payer, and organizational shifts that can frustrate and distract them from delivering high quality care. The ever-increasing demand on their time and availability, the shifting compensation models, the changing technology, and the advent of patients who expect a greater role in their care all contribute to the growth of burnout as a major challenge. In this closing session you'll hear proven solutions to prevent burnout and foster a culture of support and resiliency among clinical staff.