The Class of 2019 profiles the women and men who joined the AHA board this year.


Ensuring access to care in struggling, rurally isolated communities requires fresh thinking and creative strategies from policymakers, says Jason Spring, chief strategic officer for Kalispell (Mont.) Regional Healthcare.

Spring understands the concerns of deeply rural or frontier communities. These are remote and sparsely populated places, like parts of the western Montana region served by Kalispell Regional Healthcare – the type of places where residents are far from health care, schools, grocery stores and other necessities.

They typically are served by a clinic or a federally qualified health center or a critical access hospital, says Spring, who joined the AHA board in January. “But none of those may be the right model,” he says.

When it comes to finding right models, Spring says policymakers need look no further than the report issued in December by the AHA Task Force on Ensuring Access in Vulnerable Communities. The report points to steps that Congress and the administration can take to help protect care in vulnerable rural and urban communities. It recommends nine strategies – or models – from which communities could choose to fit their unique circumstances and protect access to essential health care services.

“The task force laid out some innovative options and performed great work for the field and for policymakers,” he says.

For example, Spring cites the report’s recommendation for establishing emergency medical centers (EMC) in rurally isolated areas. An EMC would allow existing facilities in vulnerable rural communities to continue providing emergency medical services without having to maintain inpatient beds or provide inpatient acute care services. It would help struggling hospitals to meet their communities’ needs for emergency and outpatient services.

“We need to develop new models of care, because when a rural hospital closes you lose access to health care services,” Spring says. “The hospital never reopens. Once it closes, it closes for good and the community is never the same.”

Spring served as a member for the AHA Section for Small or Rural Hospitals’ council from 2014 to 2016, and is the AHA board’s liaison to the council. He was CEO of North Valley Hospital in Whitefish, Mont., from 2009 to May 2016. He joined Kalispell Regional Healthcare last June as part of North Valley Hospital’s affiliation with the health care system.

To protect rural health care, Spring says it is increasingly important for rural hospitals to consider affiliation strategies that can help expand their scope of services, achieve greater economies of scale and financial stability and improve physician recruitment, as well as help ease the transition from fee-for-service to value-based payment. He notes that North Valley Hospital is one of 13 rural hospitals participating in an accountable care organization supported by the National Rural Accountable Care Consortium.

The uncertainty surrounding the future of the Affordable Care Act has hospital and health system leaders on edge, Spring observes, and concerned about legislative proposals that could seriously undermine health care coverage for millions of needy Americans.

He notes that “rural providers are on pretty thin margins, and the slightest policy change can have a significant impact.”

Despite today’s political uncertainty, he believes the field is invigorated by the AHA’s vision of advancing health in America and redefining the role of the “H” in a changing health care world.

“We are moving from hospitals to health, from health care to wellbeing,” he says. “Understanding how you deliver care in the community is really a sea change from taking care of an ill patient in your hospital.”