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Don Kelso is executive director of the Indiana Rural Health Association. The trade group is trying to help its members navigate the changes coming from health care reform and the financial pressures being created by federal budget cuts. The association recently launched a service for its members called SuiteStats, which is data-management software to help hospital executives identify areas ripe for cost-cutting.

IBJ: What disadvantages do rural health care providers have now compared with their larger peers in urban areas?
 
A: Reimbursement for hospitals is changing. I think SuiteStats is a fairly good tool as we move to that end. iVantage [the Maine-based company that makes the software], they take the general ledger for the hospitals that they’re working from and download it, so the hospital leadership can look at their data and they can call up a code. Like pneumonia. They can look at a lot of data so they can know the total it took to take care of you and break it down by the various components. Then it compares your hospital to other hospitals that are like you. As you look at these cost data, it points out quality issues. With physicians, it’s hard to make them change, but they do respond to data.
 
IBJ: Is this a way to help them stay independent?
 
A: That, and also the local economics. I live in Washington [where Daviess Community Hospital is located]. If this hospital fails or, for the most part goes away, it’s just going to kill this community financially. Because it’s probably $30 million to $40 million just in payroll. Plus the brain drain. The physicians, they’re some of the most analytical in the community, and they sit on boards and community organizations. If I live here, I may have to go to Bloomington or Evansville to get my appendix taken out.
 
IBJ: In the past five years, many rural hospitals have merged with larger systems because of financial pressures. Do you foresee that merger trend continuing?

A: The larger systems are less likely now to take on these failing rural hospitals, because it’s adding up on their balance sheets. I’m seeing less interest in takeovers now by larger hospitals.

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  1. Those of you yelling to deport them all should at least understand that the law allows minors (if not from a bordering country) to argue for asylum. If you don't like the law, you can petition Congress to change it. But you can't blindly scream that they all need to be deported now, unless you want your government to just decide which laws to follow and which to ignore.

  2. 52,000 children in a country with a population of nearly 300 million is decimal dust or a nano-amount of people that can be easily absorbed. In addition, the flow of children from central American countries is decreasing. BL - the country can easily absorb these children while at the same time trying to discourage more children from coming. There is tension between economic concerns and the values of Judeo-Christian believers. But, I cannot see how the economic argument can stand up against the values of the believers, which most people in this country espouse (but perhaps don't practice). The Governor, who is an alleged religious man and a family man, seems to favor the economic argument; I do not see how his position is tenable under the circumstances. Yes, this is a complicated situation made worse by politics but....these are helpless children without parents and many want to simply "ship" them back to who knows where. Where are our Hoosier hearts? I thought the term Hoosier was synonymous with hospitable.

  3. Illegal aliens. Not undocumented workers (too young anyway). I note that this article never uses the word illegal and calls them immigrants. Being married to a naturalized citizen, these people are criminals and need to be deported as soon as humanly possible. The border needs to be closed NOW.

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