Understanding Rural Health Networks Information available at www.crlconsulting.org CRL Consulting is the Technical Assistance partner for the Network Planning Grantees.

Our funder, the Federal Office of Rural Health Policy believes that Network members should pool resources to achieve common goals with a purpose of working together over time to adapt to the changing health care environment.

All Networks Increase LEVERAGE and Provide Value Members or partners work together to deliberately increase influence To overcome barriers no one organization can do on their own Provide value to partners and the community All Networks Increase LEVERAGE and Provide Value For whatever programmatic purpose that networks come together, the intent should be to join forces to do what no one organization can do on their own. Networks use their combined leverage and resources to solve problems. Networks cannot exist over time without bringing value to their members. This means that partners must complement rather than compete, and partners should clearly state the benefits they anticipate from their participation.

Types of Networks Internal External Vertical Horizontal Networks are also formed to benefit the community at large. When partners come together to address a complex issue such as childhood obesity, they seek ways to help their community members become healthier. They create awareness and provide education and supports for life style changes.   The partners may not see direct benefits in terms of cost savings in the near term. These networks are externally focused. Networks are often classified as being internally or externally focused and as being either horizontal or vertical. Early on, networks were primarily formed to benefit their healthcare provider members. Hospitals joined together to create efficiencies of scale by doing joint purchasing or sharing telehealth services. Today, hospitals and health departments may come together to conduct joint Community Needs Assessments or clinics and hospitals may form a network for care coordination. While a single facility might not be able to financially support staff for care coordination, the network might employ care coordinators that work with each of the members. These types of networks are known as internally focused networks. In these cases, the network might be selling services to the members, and the members are benefiting by sharing the costs of the services with the other members. Horizontal networks are comprised of networks where the members come from one segment of the community, such as all health care providers. Vertical networks are those whose membership is comprised of multiple sectors of the community - healthcare providers, social service agencies, schools, faith-based, among others

Formality of Organization Partnership MOUs Formal Organization Incorporation 501(c)3 Status, Bylaws Policies & Procedures Strategic Plan Business Model Business Plan Marketing Plan Depending on their purpose and formative stage, Networks may operate more like a partnership with only MOUs to bind them together. Other networks see the benefit of becoming a separate entity, so they incorporate and/or seek 501 (c) 3 status. They establish policies and procedures and produce strategic plans. And some that sell services and have multiple revenue streams operate as businesses and produce business plans and marketing plans to guide their work.

Financial Support In Kind Grants Sell Services or Products Membership Fees Successful networks combine several forms of revenue streams to support their work Most all have in-kind support from their members And most seek grants. The most strategic networks, use grants as seed money for startup costs for new programs that are then supported by selling the service or billing for third party payments. And, most internally focused networks are partially supported by fees paid by the network members.

Questions to Consider Who did we come together to serve? What is our long-term commitment? Who are our members? Who makes decisions— and how? How formal do we want our association? Will we sell or charge for services? Are we advisors to or employers of salaried staff? Here are some questions that we need to consider to determine the type of network that we want to be.