iVantage names top performing critical access and rural hospitals, facilities set high bar for struggling field

iVantage Health Analytics on Monday named its top 100 critical access hospitals and the top 100 rural and community hospitals in the nation for their high scores in terms of patient satisfaction and financial stability.

The release of the two lists expands upon research presented in February as part the firm's "2016 Relevance Study: Vulnerability to Value," which examines both top performing hospitals and those that are on shakier ground.

"The rural health safety net indeed does an outstanding job serving the roughly 63 million Americans who call 'rural' home," said iVantage Senior Vice President Michael Topchik.

[See the list: Top 100 critical access hospitals, according to iVantage]
[See the list: Top 100 rural and community hospitals, according to iVantage]

"The 'vulnerability' and 'value' bookends let us know that we have hospitals that are extremely vulnerable, and they tend to serve vulnerable populations," he said. "There has been a great crisis of hospital closures; that's part of this research. Today represents the bookend to that, meaning rural hospitals can be leaders. We can look at them as examples of what can go right, and we can learn from these institutions to provide similar care across the landscape."

Topchik added that, based on iVantage research, about 67,000 American lives could be saved annually if every critical access or rural hospital performed up to the standards of those in their respective top 100 lists.

Areas in which those hospitals particularly distinguish themselves include quality and outcomes, patient safety and satisfaction, and costs and charges.

Topchik and several of his colleagues came up with the idea to rate these hospitals about seven years ago at the National Rural Health Association's annual conference. They looked at more than 70 performance variables and wondered how they could use this public data to tell the story of hospital performance, both from an inpatient and outpatient perspective. The group especially wanted to look at the value they provided -- which the federal government has signaled will be critical in future payment models.

Rolling up disparate figures into an aggregate number, they came up with a 0-to-100 "grading" system. The median rural hospital earns an overall score of 50, while the median top 100 hospital earns a 95.

[Also: More than 200 rural hospitals are close to closure, iVantage study claims]

"The other piece is, 'No margin, no mission,'" said Topchik. "These hospitals are doing all these things on solid financial footing, so they can reinvest themselves in their communities."

He added that the practice leaders share key attributes that dovetail with the shift from volume to value.

Within the context of its research, iVantage follows the federal definition for CAHs, which includes special Medicare reimbursement rules and parameters such as the number of beds -- a maximum of 25 -- and the average length of stay for patients, which is a maximum of 72 hours.

Rural and community facilities are also federally designated, but are reimbursed by the standard Prospective Payment System of Diagnostic Resource Group-based reimbursements. The number of beds at these hospitals does not exceed 200.

"We have a lot of variability," said Topchik. "But today is about celebrating the ones who are leading the way."

Twitter: @JELagasse