Guadalupe County Hospital: Making Big Strides on Their Journey to Value-Based Care

Guadalupe County Hospital  (GCH), a 10-bed, not-for-profit, sole community hospital located in Santa Rosa, NM, was one of four organizations selected to participate in the 2020-2021 Rural Health Provider Transition Project.

During the hospital’s year-long engagement in RHPTP, GCH worked with the program’s technical assistance (TA) consultants on finance and operations improvements, as well as developing a strategy and infrastructure to improve coordination of care in preparation for participation in alternative payment and care delivery models. Below are some of GCH’s post-project measurable outcomes and top accomplishments made possible through their RHPTP participation.

GCH’s Post-Project Measurable Outcomes

• Increased operating margin by 60%
• Increased days cash on hand by 9%
• Improved HCAHP score for “Would Recommend Hospital” by 26%
• Improved operating efficiencies by 25%.  Efficiencies included optimizing all available revenue generating opportunities, maintaining an appropriately low-cost structure, embracing a measurement culture, and having effective revenue cycle controls and metrics
• 150% improvement in culture of care coordination and team-based care
• 65% improvement in informatics and analytics
• 21% improvement in organizational change management
• 150% increase in overall processes and systems to support excellence in quality improvement

Top Accomplishments

• Revised hospital discharge process based on observations and lessons learned
• Completed a root cause analysis to identify specific improvement opportunities related to coordination of care
• Initiated process for including assisted living staff in discharge of their residents
• Developed a list of community resources to address social drivers of health
• Leadership team worked in partnership with nursing staff to improve coordination of care
• Developed a measurable ongoing action plan tied to facility strategic goals
• Community promotion of quality data
• Coordination of job fairs at the schools, and development of a high school student shadowing program
• Creating a culture of goal setting

The RHPTP financial/operational and the quality improvement TA were very different, but both very helpful. You listened to us and how we were doing things and provided opportunities for improvement, not telling us we were doing it wrong. The approach and resources were appropriate to our needs. Quality and financial stability are the lynchpins for a value-based system. We have always enjoyed good quality scores and financial stability, but this project helped us dig deeper so that we didn’t just rest on what we thought we were doing ok, rather, we now have the data to support it. The project didn’t feel overwhelming, it felt nurturing and has made a strong impact on our organizational culture.

Christina Campos, Guadalupe County Hospital Administrator

GCH’s acute care, emergency medicine, imaging, pain management, laboratory, and related outpatient ancillary services span a geographic area of approximately 6,000 people across six zip codes in Guadalupe and Torrance counties.  Their medical staff consists primarily of providers at the Sunrise Medical Group (SMG), an independent, not-for-profit organization that recently transitioned its four clinics to Federally Qualified Health Center (FQHC) Look-Alike status.  SMG’s Santa Rosa clinic is located on the GCH campus and employs all service area primary care providers.

GCH continues to engage their medical staff in fostering a culture of quality and safety, leveraging telehealth capabilities to expand patient access to services, expanding population health efforts to maximize performance through several value-based payment arrangements, as well as to better understand available opportunities that result in improved financial and operational performance today and in the future related to the changing payment system.

As readmissions are reduced, and preventive care and chronic care management improve, the need for inpatient acute care has declined, leading to fewer and shorter inpatient admissions.  This trend has encouraged GCH to pursue the new Rural Emergency Hospital designation.  Hospital leadership has worked closely with the New Mexico Legislature to put the new designation into statute, and with the New Mexico Department of Health to promulgate new rules and regulations.  The new designation is slated to take effect at GCH on July 1, 2023, thus allowing the hospital to focus on quality care and community health improvement.