Smart affiliation strategies and smart federal policies will be critical to the survival of many non-urban hospitals, says AHA board member William “Bill” Carpenter III, chairman and CEO of Brentwood, Tenn.-based LifePoint Health – a health care organization that has one of the largest rural footprints in the country.

Carpenter observes that many non-urban hospitals serve as both a health care safety net and an economic anchor in their communities. But these hospitals face strong pressure related to their small size, modest assets and financial reserves and higher percentage of Medicare and uninsured patients.

Carpenter says it’s more important than ever for rural hospitals to pursue affiliation strategies that can help to expand their scope of services, achieve greater economies of scale and financial stability, improve physician recruitment, tap into more clinical and administrative expertise, and increase access to capital. At the same time, he says hospital leaders need to keep pressing Congress and the administration for legislative and regulatory policies that reflect the realities of rural health care.   

“It is increasingly difficult for rural and community hospitals to operate independently,” he says. “Two keys to survival will be aligning with the right regional or national partner, and also ensuring that their voice is heard among the lawmakers who are driving health care policy.”

LifePoint Health owns and operates 72 mostly non-urban hospital campuses in 22 states, as well as physician practices, outpatient centers and post-acute service providers. That makes Carpenter “passionate about representing the voice and perspective of rural hospitals on the AHA board.”

He notes that the “health and well-being of countless people are in our hands, so we must effectively engage policymakers at all levels and advocate to protect the interests of our hospitals across the country.”   

Carpenter knows a lot about aligning with the right partners to improve operational efficiencies and community services. LifePoint Health has been active in realignment – a trend Carpenter says cannot only help meet the current health needs of patients and communities, but also provide a stable foundation upon which to build the health care system of the future.

For example, he cites the joint venture partnership between LifePoint Health and Duke University Health System that led in 2015 to the LifePoint National Quality Program for affiliated hospitals. The partners formed the program on the heels of LifePoint's participation as a Hospital Engagement Network (HEN), a nationwide project established by the Centers for Medicare & Medicaid Services in 2011. LifePoint participated in two rounds of the HEN and reported a 49.6% reduction in health care-acquired conditions at the end of its second contract in September 2016.

The LifePoint National Quality Program continues those clinical improvement efforts. When LifePoint hospitals enroll in the program, they work with Duke and LifePoint quality coaches to evaluate and strengthen their quality programs and processes. Following an initial evaluation, a hospital creates a plan and begins to implement changes that will help it achieve quality improvement benchmarks and establish long-term solutions to sustain its results.   

“It’s a structured process for ensuring consistent, high standards of quality and patient safety … and provides the tools, coaching and resources necessary to help our hospitals improve patient care,” Carpenter says. “This type of scalable resource would be difficult to find through a service-line-specific affiliation and demonstrates one benefit of mergers and acquisitions for our hospitals.”

Carpenter joined the AHA board last month. He has served as CEO of LifePoint since 2006 and became its chairman in 2010. He is a founding employee of the company, which was established in 1999, and has served LifePoint in a number of leadership roles. He also is secretary and past chairman of the Federation of American Hospitals.  

Carpenter is a lawyer by background – like his father and grandfather – and believes his legal expertise has helped him navigate health care’s complex regulatory environment.

His recipe for success: “Think strategically and inspire people to do meaningful work.”

In a rapidly changing health care world, Carpenter observes that the word “hospital” is becoming less about a building and more about a coordinated system of care.

“The idea of redefining the ‘H’ is exciting for us,” he says. “Today, our company is addressing comprehensive needs across the continuum of care. And our hospitals are often at the center, coordinating the pieces of the health care puzzle in their local markets.”