Community hospitals across the country are in a tight spot. 

Leaders tasked with maintaining independence are pressured to turn refreshed strategies into productive realities—a job that’s only gotten increasingly difficult as long-term impacts of the COVID-19 pandemic play out in a range of areas including supply chain management, adjusting emergency preparedness, and providing data to government agencies and state reporting bodies. 

HFMA has stepped in to offer essential tactics to help community hospital leaders sustain their independence. We want to review those for you and present resources to help you move forward on each. 

Enabling Collaboration to Support Virtual Integrations

HFMA stresses a paradox here: While many community providers pride themselves on fierce independence, those same hospitals use collaboration and reliance on others to go their own way. 

Successful independent community hospitals partner to create virtual integration, something that often begins in non-clinical and administrative functions. One example is Arkansas Rural Health Partnership and their ability to create scale through tactics like shared staffing agency support and  shared laundry and linen services.


Finding your areas of opportunity will require deep insights into efficiency and cost to identify the areas where you’ll see the most potential benefit from this type of “virtual integration”. You will need to leverage these insights to pin down the areas of opportunity where you might not have expertise, IT infrastructure, or patient volumes on your own to create sustainable results and should then look into virtual integrations. 

Emulating High Performers to Optimize Recruitment and Retention

The rate of clinician exits from healthcare has been nothing short of alarming—a recent survey of healthcare professionals found that 67% reported plans on leaving, with 11.3% planning on existing within the next six months. Mississippi alone has seen 2,000+ nurses resign since the start of 2021. This means that independence for community hospitals will hinge on being able to recruit and retain talent.

One answer to this staffing challenge is investing in the clinician experience. You’ll need to reduce pain points for your staff, allow for self-scheduling, and make an effort to offer competitive pay and reduce burnout. Much of this will rely on reducing costs and transforming overhead departments. 


As you investigate your clinician experience and look for ways to provide a great place to work while balancing costs, you’ll see benefits from financial support tools that do a few things including:

  • Identifying savings opportunities by comparing utilization to labor resources
  • Giving your managers user-empowering reporting and high-level insights
  • Establishing productivity reporting
  • Aligning your efforts with budget and planning goals 

Break Down Communication Silos to Engage More Stakeholders

HFMA stresses the fact that a hospital’s independence relies on tight workforce alignment and coordination with care communities. This means that both the local community and employees will need to feel a sense of ownership to stay engaged in a way that supports sustainable independence. Leaders will need to open the strategic planning process to input beyond the C-suit and board so that all levels of the organization can contribute. 

The association suggests an “open strategy” process as one answer in which employees and community provide input. For many organizations, this could be a shift in culture, and many will find that they will benefit from first addressing how they communicate—decentralizing decisions within the organization before extending the process to the community level. 

Make sure the strategic and operational tools you’re working with provide easy access to reports for users at all levels, and that they foster improved communication and collaboration. You will also need to ensure that you have an easy and tech-enabled path to evaluating decision impact on staffing, resources, and financial outcomes—this is along with improved performance metrics that you can easily share with stakeholders who might be newer to this type of process. 


Keep in mind that this is a journey, and one where you can look to other community hospitals’ experiences in maintaining their financial independence. Learn more about your options from this Oi Health Story about Columbia Memorial Hospital and their success in maintaining independence through a focus on revamped financial management tools.