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Richard Watson of Motient talks about helping rural hospitals stay afloat


More than 130 rural hospitals have closed since 2010. Watson, the co-founder of Motient, a healthcare technology company, spoke with Chief Healthcare Executive about sustaining rural hospitals.

Rural hospitals have been fighting for their survival for years, and Richard Watson says the situation is becoming even more troubling.

A physician, Watson has spent years in rural emergency medicine in Kansas and Alaska. He’s also the co-founder of Motient, a healthcare technology company that works with hospitals and health systems on patient transfers.

“We’re looking at an untenable situation from a rural standpoint,” Watson told Chief Healthcare Executive in a recent interview.

Since 2010, 138 rural hospitals have closed, according to the Centers for Medicare and Medicaid Services. Analysts say hundreds of other hospitals face legitimate risk of going under.

Watson talked with Chief Healthcare Executive about the rural hospital landscape and the need to revamp the funding of rural hospitals. He also discussed how his company is working with rural hospitals to get more information about their patients.

At many hospitals, over half of the patients they treat are covered by Medicare or Medicaid. Those reimbursements aren’t sufficient to sustain rural hospitals, he said.

“Healthcare has to make some decisions because we are at a frail point,” Watson said. "It’s very fragile right now. Hospitals are aware that they’re at the edge.”

Despite their funding challenges at rural hospitals, "We still have a number of people we have to take care of."

President Biden’s administration has proposed a new mechanism to help rural hospitals. The CMS is planning to create a new provider designation dubbed “Rural Emergency Hospitals.” It will enable small, rural hospitals to provide access to emergency services and outpatient services, CMS said. Watson said he supports the idea.

“I think there’s a lot of good thought that went into this,” Watson said.

Lawmakers in Congress are also pushing a bill to extend the life of two key programs providing about $600 million annually to rural hospitals.

U.S. Reps. Carol Miller, a West Virginia Democrat, and Terri Sewell, an Alabama Democrat, have sponsored the Assistance for Rural Community Hospitals (ARCH) Act. The bill would extend Medicare programs designed to help smaller, rural hospitals for an additional five years. The funding for those programs expires at the end of September. A similar bill in the Senate would extend the programs permanently.

Ultimately, the funding of rural hospitals needs to be revamped, Watson.

“If they were to recognize a critical healthcare level that needs to be present, and we supplement based on that, it changes the feeling of rural hospitals,” Watson said.

Watson’s company, Motient, has been very involved in helping rural hospitals navigate the challenges of the COVID-19 pandemic.

Motient has partnered with the Kansas Department of Health and Environment to track transfers between hospitals. Kansas hospitals, along with the state’s prisons, have been using Motient’s “Mission Control” platform to arrange data. The platform also allows hospitals to gain valuable data about the patient transport process.

With the platform, hospitals haven’t had to burn time on the phones trying to find available beds. They’ve been able to use Motient’s to find available hospitals and arrange transports.

“We can take the burden of dinding the transport system while we do the logistical work,” Watson said.

Ashley Goss, deputy secretary in the Kansas health department, said in a statement last December, “Motient's assistance has been invaluable during the pandemic, and its 24/7 communications team has helped our communities weather the hospital capacity crisis.”

Motient also is providing rural hospitals valuable data that could help them offer better care for patients, Watson said.

“Motient’s job is to help them understand you’re moving 20-30 people through the emergency department,” Watson said. “They have a chance to capture part of that.”

Patients who aren’t seriously ill could be candidates to be treated in their hometown, rather than transferred to a facility far from their families and loved ones, Watson said.

With data from Motient, hospitals can learn more about the patients going through their hospitals and develop new services. For example, if a hospital is seeing an uptick of patients with diabetes, the organization could consider developing a telehealth or remote patient monitoring program to help patients manage the disease.

It could help avoid hospital stays that are expensive for the patient and the provider

“Not only is it more cost effective, it gives sustainability to those local facilities,” Watson said. “Know what's coming in and out of your hospitals. Use the data to make your system profitable.”

So far, about 140 facilities are using Motient’s Mission Control solution. Most of Motient’s partners are in Kansas, but the company is also working with facilities in Nebraska, Missouri and Louisiana.

Rural hospitals need as much help as they can get.

More than 500 rural hospitals are at an immediate risk of closure due to economic difficulties, the Center for Healthcare Quality and Payment Reform reported. An additional 300 rural hospitals are looking at high risk of closure because they have low financial reserves or because they rely heavily on government funding and sources of revenue beyond patient volume.

Watson, who spent most of his clinical career serving patients in towns with under 15,000 people, said the government should offer more incentives to get doctors to practice in rural areas.

The Biden administration is directing $52 million from the American Rescue Plan to train rural healthcare providers. Watson said directing more money to train young doctors, with a requirement to work in rural hospitals for a certain amount of time, would improve healthcare in rural areas.

“It does create a flow of new talent into rural areas,” Watson said. While many of these providers may only practice in rural areas for a few years, Watson said, “it gives these communities a vibrant health scene.”

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