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The number of hospitals trying to treat an older, sicker population with a smaller clinical staff is set to decline, leading hospitals and health systems to spearhead the building of community partnerships to prepare for that era, health care executives said.

LifePoint Health is putting together a “cast of thousands” of community partners to tackle the problems confronting its hospitals because the challenges are too unwieldy to be battled alone, said Dr. Russell Holman, chief medical officer of LifePoint Health.

Hospitals are besieged by a variety of challenges. An aging population, the opioid epidemic and “an obesity tsunami” on top of the clinician shortage and budding consumerism are recasting how hospitals deliver care, said Holman, speaking at a Health Care Council Panel called “Health Care Next.”

Holman, reciting those almost as verbal bullet points, said the model of care has to change to encompass those challenges — and more.

LifePoint is assembling a “tremendous amount of partnerships,” including public health departments, local pharmacies as well as chapters of Meals on Wheels and YMCA branches.

“The list goes on,” Holman said, because each of the agencies have been working independently to try to solve problems. “And how far have they gotten?”

The Little Clinic’s Dr. Marc Watkins, chief medical officer (L), moderates a discussion between his counterparts at LifePoint Health and HCA Healthcare, Russell Holman (second from left) and Jonathan Perlin, and Linda Finkel of AVIA about the future of care delivery at a Nashville Health Care Panel on April 25, 2018.

Health systems are trying to move patients into lower cost, more efficient settings of care — urgent care and ambulatory surgery centers continue to be hot strategies — as everyone from employers and patients to insurance companies fret about costs.

But HCA Healthcare’s Dr. Jonathan Perlin, chief medical officer, said hospitals will still play a leading role well into the future — because higher rates of overlapping chronic disease mean that patients are sicker.

“We’re pretty bullish on the business of hospitals,” said Perlin. “We see that as a core that remains necessary with the burden of disease.”

Hospitals are the epicenter of specialized care, but in small towns — such as LifePoint’s market — they are the primary economic engine. Without hospitals and education, businesses don’t want to expand and people don’t want to live there.

In Tennessee, reversing the plight of small town hospitals underpins gubernatorial candidates’ approach to sustaining the rural areas.

Holman said the estimate that one-third of hospitals in the country are at risk of closing is as  “good a number as any” when it comes to projecting how many could shutter.

The forces unleashing economic pressure on facilities, range from — but are not limited to — technology costs, changes in patient preference, shifting demographics, challenges recruiting new physicians and the size of the patient load.

The factors closing hospitals, are both reflective of and and stem from the issues plaguing people’s ability to be healthy, said Holman, listing social determinants, access, cost and environment to impediments of health as well as cost drivers for hospitals.

“Within rural communities, you cannot solve the issues as a hospital or health system, the issue is bigger than that,” said Holman. “In order to solve those problems, we have to treat them as community problems.”

It’s important for hospital operators with a track record of execution and operations to help, said Perlin, referencing a program in which HCA hospitals use telehealth technology to assist outlying hospitals administer stroke care.

Collaborative approaches are key in rural or urban areas, and hospitals shouldn’t be sluggish in taking action, said Linda Finkel, president of Chicago-based AVIA, which helps a network of health systems, mostly in metro areas, use data to solve problems.

“Never slow down your system from acting as fast as it can,” Finkel said.

Feature photo by Tanner Mardis on Unsplash