1. Alternative Models for Rural Healthcare Delivery
Nebraska Rural Health Conference
April 24, 2019
Marty Fattig, Chairman
Rural Health Advisory Commission

2. Rural Healthcare State of Affairs
Bad and getting worse
39 of 71 Nebraska Rural Hospitals have 2% margin or less
29 Have Negative Operating Margin
11 Have Had Negative Margin for Three Years or More
22 Have an Operating Margin Below Negative 3%

3. All Reports Say The Same Thing
iVantage Report
Modern Healthcare Article
American Hospital Association Article
CBS 60 Minutes Exposé
Other Reports

4. Nebraska Alternative Plan – Where it Began
Phone Call – May 2017
Discussion With Rural Health Advisory Commission at June meeting
Charged Me With Developing a Group to Study the Issue
Issue: How do we sustain healthcare services in a community that can no longer support a hospital?
First Meeting 8/23/2017

5. Those Asked to Participate
Rural Health Advisory Commission
Nebraska Rural Health Association
Nebraska Hospital Association
Nebraska Medical Association
UNMC
Rural Futures Institute
Dave Palm

6. Added Later Nebraska Health Care Association
Nebraska Office of Rural Health

7. Changed Focus
Changed focus from what do we do if a community cannot support a hospital to what can we do to keep hospitals for getting into this situation.
Factors that are responsible for vibrant, successful rural communities are the same factors that are responsible for vibrant, successful rural hospitals.

8. Meetings Held at NHA Offices
August 23, 2017
November 6, 2017
January 19,2018
Michelle Rathman, Impact Communications
Office of Rural Health Funding
Support a person to conduct Listening Sessions

9. Listening Sessions Five Sessions held across the state
Auburn
York
Lexington
Grant
Norfolk
Report from Listening Sessions Prepared
Meeting Held with Initial Group March 21, 2019

10. Next Steps List of three or Four things to focus on
Search for Grant Support to Write Plan for Pilot Project to request Center for Medicare and Medicaid Innovation (CMMI) Federal Grant

11. Your Thoughts? What needs to happen for us to be successful?
What have we missed?
What should the pilot project look like?

12. Marty Fattig mfattig@nchnet.org