The Science Journal of the American Association for Respiratory Care

1998 OPEN FORUM Abstracts

Coping with Health Care Change in Rural America

Colleen Schabacker, BA, RRT

Surviving in health care is a constant challenge no matter how large or small your facility is. It seems as though large medical centers are becoming larger with powerful medical direction, research grants, large foundations and such, while medical centers in rural America are trying to just keep their heads above water. Some have been forced to close their doors, while others are restructuring, combining departments, depleting departments, and giving unqualified personnel jobs to do without the proper training. With the Balanced Budget Act coming of age, financial cuts are a fact of life. At a time when the public is becoming more knowledgeable about their healthcare needs, hospitals everywhere are struggling to provide high quality care with high quality equipment, paying high salaries to obtain and maintain qualified personnel, plus give insurance companies and other payers what they want with less and less reimbursement. While large hospitals are usually able to hire the people needed to keep up with government regulations through utilization review and experts in billing, coding, OSHA and CDC regulations (just to mention a few) rural hospitals are pulling from within to accomplish these identical tasks.

Middle managers in rural hospitals wear many hats - they need to know billing processes, coding processes, information management, local politics, the players and the rules. They have to keep abreast of everything. Being intimately familiar with the information management system in your facility is a number one must. How do you do that? You have to take in the same information your CEO and CFO do. You need to know all of your middle managers so you can inform them, your CEO, CFO, and medical staff about what is going on in your facility. If you know the people and the politics in your rural hospital, you can make effective changes and realize the ripple effect throughout your organization without going through a huge bureaucracy. These procedural changes, that mean little to these people, can acutely make a large difference in how you do things - how you get the work done.

The 44th International Respiratory Congress Abstracts-On-DiskĀ®, November 7 - 10, 1998, Atlanta, Georgia.

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