From Nice-to-Have to Need-to-Have The Evolving Role of Strategic Partnerships for CAHs

Financial, workforce, and operational pressures are accelerating across rural healthcare. In this environment, collaboration is no longer optional. For CAHs, strategic partnership models — from rural health networks to shared service collaboratives, regional affiliations, specialty service partnerships, and innovative value-based alliances — are becoming foundational to long-term sustainability.

This session will explore how active engagement in rural health networks and other emerging partnership structures has shifted from a “nice-to-have” to an essential strategy for maintaining local governance while strengthening collective capabilities, resilience, and negotiating leverage.

Drawing on real-world examples from rural health networks Stroudwater has worked closely with, including the Eastern Plains Healthcare Consortium in Colorado and the Montana Health Network, we will highlight how intentional collaboration can support shared services, workforce development, care coordination, payer strategy, advocacy, and access to capital.

The session will also provide practical insight into how rural health networks are structured and how they are established, offering a clearer view of the governance models, shared services arrangements, and early alignment steps that help move collaboration from informal relationships to formalized partnerships.

Finally, we will explore how CAHs can engage larger health systems as strategic partners while maintaining appropriate governance, accountability, and community alignment — a balance many rural leaders are navigating as they pursue scale and sustainability.

For hospitals not currently participating in a network or formal partnership, the session will outline practical starting points and considerations for evaluating whether a network or partnership structure may support their long-term strategy.

At the end of this session, participants will be able to:

  • Differentiate between rural health networks and other emerging partnership models, and assess which structures best align with their hospital’s strategic goals.
  • Understand how rural health networks are formed and governed, including common structures, shared service models, and early steps for hospitals exploring network participation.
  • Identify the operational, financial, and workforce advantages of partnership engagement, including shared services, payer strategy alignment, advocacy strength, and specialty service expansion.
  • Evaluate partnership opportunities with regional health systems while maintaining appropriate governance, accountability, and community alignment.
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Q&A

How do people stay on top of all the payer newsletters to sort through everything to pull out applicable information for the facility/provider? Who typically is going through the newsletter to gather the information to share with other staff?

Our billing specialists are organized by payer, allowing them to develop deep expertise in their respective areas. Each specialist subscribes to their payer’s newsletters to stay informed about updates and changes. Additionally, our team leads, Supervisor, and Director of Patient Accounts—along with the Prior Authorization Team—collaborate to share key insights and ensure the entire team stays up to date. This collective approach enhances our ability to navigate payer policies efficiently and provide the best possible service. 

What leadership structure do you have in place for your revenue cycle and who or what do you use for training when billers or coders need it? Especially for new service lines or common denials?

Our billing specialists are supported by a structured leadership team, including two team leads, one Supervisor, and one Director. Training for billing specialists is conducted by our Supervisor and team leads to ensure consistency and expertise. Additionally, billing specialists meet weekly with leadership to review denials and identify payer-specific trends. For new coders, who are required to be certified, training is led by our Coding Lead to maintain high standards of accuracy and compliance.

Are the billers assigned based on an alphabetical split or by insurance type, such as Medicare and Medicaid specialists?

Billers are first assigned by insurance type and then further divided by alphabetical split. Since each insurance type has multiple billers, the alpha split helps distribute the workload efficiently.

Since we have union employees, how could we implement a similar incentive to Kindal’s while ensuring compliance with union regulations?

This would depend on the specifics of your union contract. Stroudwater can work with you to review the contract and develop a compliant incentive model.

Does your Coding/HIM department manage CPT coding, modifiers, and ICD-10, or do they focus solely on ICD-10?

Our Coding team handles all aspects of coding, including CPT, modifiers, and ICD-10. They thoroughly review all provider documentation to ensure accuracy and compliance.