GRAND FORKS — An organization aimed at supporting small-town, independent hospitals has helped facilities in North Dakota and Minnesota form their own rural health networks. Personal experiences working in the field and the changing landscape of health care drives the team behind Cibolo Rural Health Networks. Nathan White, president and CEO of Cibolo, said the organization strives to make sure small-town hospitals can stay open and independent.
“How can we keep these rural hospitals not just surviving but thriving?” he said. “I think that’s the fundamental challenge that really gets us energized, and to see their energy around new opportunities is also just enormously positive. So, that’s kind of what we do this for.
” ADVERTISEMENT Cibolo works with independent, rural hospitals to create clinically integrated networks — groups of health care providers working together to improve quality of care and reduce costs. Cibolo has created two networks so far in its existence. One is the Rough Rider High Value Network in North Dakota, a collaboration of 23 hospitals and 41 clinics.
The other is the Headwaters Network in Minnesota, between more than 50 clinics and 19 hospitals, though the latter is anticipating growth. The networks work with insurance companies to create value-based care contracts, which Cibolo Chief Medical Officer Clint MacKinney said is different from what is prevalent across the country. Many health care providers are paid based on how much service they provide, even if it doesn’t help the patient, which he said he does not like.
“It sounds a little bit cynical, and maybe it is, but I would tell folks that as a doctor, I’ve got paid the more I did to you as a patient, whether it helped you or did nothing for you,” he said. “And I think that’s fundamentally, if not morally, wrong.” Value-based care, in comparison, rewards doctors and hospitals for continuously improving the quality of care and service that they provide to patients and responsible use of health care funding, he said.
Cibolo came to be with the creation of the Rough Rider network. Three-and-a-half years ago, a collection of hospital CEOs in the state started a conversation about how they could work together to share best practices and resources, improve clinical performance and make the investments that would make those goals possible. It was a new frontier, White said, and the group wasn’t sure what the collaboration was going to look like.
For months before Rough Rider and Cibolo officially formed, there were numerous conversations with the CEOs on what was important to them and how the group could be structured. The hospitals’ main goal was to remain independent. Some in the state had to partner with larger health systems to stay afloat, which wasn’t the direction Rough Rider wanted to take.
“The mantra was ‘independence through interdependence,’” White said. Cibolo formed to be a cross between a consultant and management company, he said, helping Rough Rider members figure out how to structure and run the network. CEOs of rural, independent hospitals in Minnesota took note and reached out, leading the more recent creation of Headwaters .
Cibolo’s goal as of now, White said, is to prove the concept of these networks does work and that it makes the communities served better from a clinical perspective. ADVERTISEMENT MacKinney added that Cibolo is working on the “triple aim,” a common term in health care referring to the three primary aims health care systems should have – improve patient care, improve community health and use resources wisely. “And that’s what we want to deliver,” he said.
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