Alaska's rural hospitals: new innovations help address challenges.

• Author: Sommer, Susan
• Position: HEALTH & MEDICINE

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Open 24/7, staffed and ready to admit patients for everything from dire injuries to cancer treatment to physical therapy, a hospital is always ready for guests who hope they never have to visit. Small, rural hospitals are legally bound by the same laws as larger urban facilities. So how are Alaska's rural hospitals--many of which are far off the road system--faring these days?

Challenges for Rural Alaska Hospitals

"Health care and hospital care in particular is changing and improving rapidly in the US. It is increasingly complex," says Karen Perdue, president and CEO of Alaska State Hospital and Nursing Home Association. "Small hospitals need to and strive to comply with the same complex rules as their larger peers. Special challenges include low volumes and the need to maintain surge capacity. Most people will use the inpatient part of the hospital very infrequently in their life, but when they need the service it must be open and ready to serve. In addition, some of our hospitals see seasonal surges in need--such as Ketchikan and Homer."

Challenges for Alaska's rural hospitals are many, including high costs of doing business in Alaska, finding and retaining professional health care workers and keeping up with technology.

Costs

Seventy-five percent of Alaska's communities are not connected by road to a hospital. It's expensive for rural patients without a hospital in their community to travel to the nearest one or to one of the state's bigger hospitals for more serious treatment and care. A recent Alaska Health Care Commission study found that hospital payments are 38 percent higher in Alaska than in six other western states. The farther away Alaskans live from the hospital the less likely they are to get timely needed care, and the more it costs to treat them.

Rural hospitals must be in compliance despite the higher costs associated with Alaska's vast geography; that often means passing the costs on to the consumer, or spending time and resources to find grant funding. Transportation of goods and equipment alone to rural communities results in increased prices for associated services offered to residents.

By law hospitals cannot turn away anyone needing care, even if they are unable to pay. In 2009, Alaska hospitals reported $410 million in lost revenue from underpayments and uncompensated care.

Staffing

Another challenge is recruiting and retaining qualified staff; it takes a certain type of person to live...