Executive Summary

As part of its ongoing effects to improve access to health care service in rular communities, the primary
focuses of this project is to establish a provider based Medium Clinic in small town

The primary focus of this project is to explore the need to establish a provider-based Rural Health

Clinic in a small, rural community and provide a strategic solution to needs identified. A rural

area, as defined by the United States Census Bureau, is an area that encompasses all population,

housing, and territory not included within an urban area which is defined as areas with greater

than 2,500 people. https://www.census.gov/geo/reference/urban-rural.html

Living in a rural area has many challenges, one of which is convenient access to quality

healthcare. Lack of accessible healthcare in rural communities has a negative impact not only on

the quality of life and health for the residents, but it also puts a dramatically increased burden on

the Regional Medical Center’s Emergency Department to provide non-emergency services to

residents who do not have access to a more appropriate level of care, such as an outpatient clinic.

By establishing a non-physician staffed clinic that is easily accessible by residents, the quality of

life would dramatically increase due to timely delivery of health care services. Additionally, this

approach would shift the burden from the emergency department as the first line of medical

treatment, which would improve cost value for the resident, community as well as the Regional

Medical Center.

Executive Summary

1) Company

The Regional Medical Center is a 325 bed, county owned hospital that has established a

multi-specialty medical group, Regional Medical Group (RMG), comprised of 20 Physicians

and 5 Nurse Practitioners. Single and multi-provider clinics are located throughout the city.

RMG desires to expand into other parts of the county and surrounding communities in order

to increase market share as well as provide needed healthcare services to the rural

communities that are 20+ miles away from the hospital.

household income of $16,136. The surrounding communities within a 70+ mile radius would

provide approximately 5,000 additional lives. http://www.city-data.com/city/ArcolaMississippi.html

The provider-based rural health clinic will be staffed by non-physician healthcare providers

and visiting specialists including Cardiology, ENT, General Surgery, Colon & Rectal

Surgery, Obstetrics & Gynecology and Orthopedic Surgery. This model of healthcare is not

currently offered within the community and would draw not only people from the immediate

area but could extend to a 70+ mile radius.

2) Market Opportunity

As the healthcare landscape continues to shift to outpatient-based services, the RMG is

positioning itself to meet this need in the rural communities. The closest primary care clinic is

located 8 miles away in a neighboring community. Specialty medical services are located in

the county seat located 20 miles North, but many residents of the community do not have

reliable transportation and experience financial limitations. Public transportation is not available within
the county, and non-emergency medical transportation is funded through

grants and is limited or unreliable at times as it is headquartered 37 miles away.

3) Capital Requirements

Capital expenditures for the first year are estimated at $250,000 for start-up costs including

$180,000 for building acquisition, $20,000 for furniture & fixtures, and $50,000 for

equipment including medical, computers and telephones. This will be a budgeted expense

funded 100 percent by the Regional Medical Center.

4) Mission Statement

The Regional Medical Center’s mission is to provide high quality medical and preventive

services to the citizens and communities in the region at the lowest practical cost and be a

leader in providing needed support services to healthcare providers and patients to improve

the health of the communities we serve.

To be the best healthcare organization in the state in which to receive care, practice medicine

and work

Our Values

• Compassion

• Accountability

• Respect (Golden Rule)

• Excellence

• Education

5) Management

Executive Director: Healthcare Administrator with Certification or Fellowship through the

American College of Medical Practice Executives, Master’s degree or minimum of seven to

ten years of healthcare management experience. This individual will possess strong problem

solving, decision-making, analytical, communication, critical-thinking and interpersonal

skills. Will collaborate with key stakeholders to insure seamless delivery of care.

Medical Director: Licensed Physician with experience leading providers in a multi-specialty

organization as well as supervision of healthcare staff.

Office Manager: Will possess a bachelor’s degree or minimum of 5 years healthcare

management experience. Will oversee the day to day operations of the clinic including

clinical and front office areas. This position may be shared between multiple locations

depending on volume and need.

Rural Health Clinic Start-up

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6) Competitors

No competitors exist in the immediate service area. The closest clinic is located in a
community 8 miles away. This facility is independently owned and provides primary care

services through one physician and one nurse practitioner. The strengths and weaknesses of

this competitor are listed below.

Strengths:

• Longstanding in the community

• Primary Care services

• Located near a main transportation route

Weaknesses:

• Lacking access to specialty care

• Located outside of the targeted service area

• Not utilizing EMR

7) Competitive Advantage

The RMG is well positioned to take on this new venture and provides the following

competitive advantages.

• Linked with the Regional Medical Center that provides access to multi-faceted, quality

care

• Primary Care with Specialty Services

• Easily accessible within the immediate community and surrounding areas

• Part of an Accountable Care Organization (ACO) which supports quality care with

reduced cost

• Utilization of the EMR that the Regional Medical Center and other primary care and

specialty providers use.

8) Financial Projections

The Rural Health Clinic has a positive financial projection in the first year of $177,553 based

on the financial analysis exercises performed as part of this plan. The start-up costs of the
clinic are relatively inexpensive due the low cost of the facility as well as the lower provider

salary for a nurse practitioner. The physician specialists’ salaries are not included as this

expense is already captured in their home department.

Summary

a) Mission

The mission of the Rural Health Clinic is to provide convenient access to high quality

primary and specialty care to those living in the small, rural community and surrounding

areas as well as to reduce non-emergency utilization of the Regional Medical Center

Emergency Department and preventable hospital admissions. Long term goals are to improve

the health and quality of life of the residents as well as enhance the healthcare services

offered in the extended service area.

b) Business Model

The Rural Health Clinic provides a distinct opportunity to offer primary care and specialty

services to an area that is unurbanized and that has been designated as a health professional

shortage area according the Health Resources and Services Administration (HRSA).

https://data.hrsa.gov/tools/shortage-area/hpsa-find The clinic will serve as the only healthcare

facility in the community and will be classified as a Provider-based Rural Health Clinic.

A location has been identified that is central in the town and on the main road which allows

for easy access and prime visibility for residents seeking care. The existing structure on the

location is uninhabitable and will be torn down after approval from the City Board. A

modular building installation will allow a cost effective and timely solution so that services

can be provided as soon as possible.

The clinic will offer both primary and specialty care under the Rural Health Clinic Guidelines

established by the Centers for Medicare and Medicaid Services (CMS). A nurse practitioner,

who is already employed by the Organization, will provide services at least 50% of the
clinic’s operating hours while specialty providers, who are also currently employed, will

rotate though the clinic on a scheduled basis depending on demand for services.

The clinic will furnish certain laboratory and diagnostic services as outlined by CMS. These

include blood glucose, hemoglobin or hematocrit, occult blood stool examination, pregnancy

tests, primary culturing for transmittal to a certified laboratory and urinalysis by dipstick or

tablet method. The clinic will also offer phlebotomy services to allow patients the

convenience of complying with their healthcare provider orders for labs without having to

travel to the Regional Hospital or other reference lab.

The clinic will implement the same EMR that is utilized by the Regional Medical Center

including the physicians and nurse practitioners employed by the hospital. This EMR

integration will improve coordination of care and the elimination of duplicate or unnecessary

testing and procedures. Not only will the Rural Health Clinic serve the local community but

will be a healthcare resource for many in the neighboring communities.

c) SWOT Analysis

Rural Health Clinic Start-Up SWOT Analysis

Strengths Weaknesses

• Largest employer in the County

• Brand recognition

• Integrated EMR

• Experience with clinic services

• Engaged providers

• Community is onboard

• Local convenience

• Cost of establishing a new facility

• Changing patient behavior in where

• Lack of patient engagement in

utilizing Patient Portal

Opportunities Threats

• Increasing market share

• Partnering with communities to

improve their health

• Measuring patient satisfaction

• Develop patient focus group to

increase patient engagement

• Small community

• Area health providers may view as a

threat

• Unexpected barriers when tearing

down existing and placing new

facilities

d) Strategy

Initial objectives for the Rural Health Clinic are as follows:

• To create a medical facility that will meet the needs of the local community for

primary and specialty care

• To provide high quality care to the patients we serve

• To improve health outcomes of the patients we serve

• To achieve and exceed quality measures as defined by CMS and as part of the ACO

Future objectives for the Clinic include:

• Implementation of a Chronic Care Management (CCM) program

• Increase market share for the Organization

e) Strategic Relationships

Strategic relationships currently in place include:

• Employed provider relationships including primary care and the following

specialties: Cardiology, Colon & Rectal Surgery, ENT, Gastroenterology, General

Surgery, Infectious Disease, Obstetrics & Gynecology, Orthopedic Surgery and

Pulmonology

• County and Local government relationships

• Laboratory services

• Radiology services

• Home Health & Hospice

• Cardiac Cath Lab and Cardiac Rehabilitation

• Physical and Occupational Therapy

• Wound Healing Center

• Sleep Facility

• Mental Health Services

f) Key Stakeholders / Key Decision-Makers

This project includes the following stakeholders and decision-makers:

• Board of Directors

• Chief Executive Officer

• Chief Financial Officer

• Chief Clinical Officer

• Executive Director

• Physicians and Nurse Practitioners

• Clinic team members

• Patients

• Local community government

• Community members

• ACO members

• Payers

2) Products and Services

The Rural Health Clinic will provide primary care and specialty services in the community.

Services will be provided for patients of all ages. Specialty services are provided as a service

of the employed physicians of the RMG. The specialties offered will be as follows.

• Primary Care and Preventive Services