Thanks to a partnership with Dr. Mandeep Sahani, a Phoenix-based nephrologist with Desert Kidney Associates, patients in Globe, AZ and surrounding areas in immediate need of dialysis don’t have to travel by helicopter or ambulance to Phoenix.
Cobre Valley Regional Medical Center CEO Neal Jensen,
Overall, it’s been nothing but a positive. All those patients now stay here. All that business stays in the local community, which is very positive for the hospital.
Before the innovative partnership, dialysis patients were forced to take an ambulance to a hospital an hour away from family and friends. And what followed the patient was a sizable hospital bill paired with emergency transportation expenses ranging from $2,500 for ground services to a whopping $50,000 for air transport.
Today, patients needing dialysis at Cobre Valley consult with Sahani via telemedicine and, if necessary, are administered dialysis at the hospital from trained nurses and dialysis technicians. This system has been a win-win-win for patients, their families, and the hospital.
Access to care is critical for people with kidney disease and recent studies have found people with chronic kidney disease in rural areas suffer worse health outcomes than those in urban areas.
Desert Kidney Associates Managing Partner Dr. Mandeep Sahani,
“Getting dialysis now is better than getting dialysis a couple of hours later.”
For dialysis patients, traveling back and forth to Phoenix was “really very burdensome on them and their families,” said Cobre Valley’s Chief Nursing Officer Rhonda Mason. “To be able to provide [dialysis] here, where their families are close and they can come in, I really think it’s made a huge difference.”
The “great-enabler” that made this partnership possible was a new, simpler dialysis machine from NxStage. Sahani worked with Rhonda Mason to train the staff at Cobre Valley to use the machine and initially, they said, there was apprehension to adopt the new treatment. But over time, they developed trust and confidence and now nurses and technicians express satisfaction with the enhanced education and experience.
“The first one was really challenging, and they just got easier and easier as time went on,” Mason said. “Today, it’s just another intervention that we do…in all our departments.” Mason said DKA “made it easy” for the hospital staff. “Sahani has a way of instilling confidence with the providers as well as the patients and staff,” she said. “He’s incredibly patient and thoughtful, and so knowledgeable.”
Cobre Valley is one of Arizona’s 15 critical access hospitals (CAH), according to the University of Arizona’s Center for Rural Health. Such hospitals provide 24/7 emergency care, have no more than 25 inpatient beds, and have no other hospital within a 35-mile drive.
Hospital margins have taken a huge hit during the pandemic across the board, and rural hospitals—which often struggle financially—are no exception.
According to a 2021 study from the Chartis Center for Rural Health, 453 rural hospitals (including CAHs)—a full quarter of all those in the U.S.—are currently at imminent risk of closure. Arizona’s CAH hospitals, like Cobre Valley, become a community’s healthcare hub and a trusted resource for all patients, including those on dialysis. But, as Sahani notes, “They’re always cash-flow crunched.”
By keeping emergency dialysis procedures local, Sahani and Jensen’s partnership provides a financial boost to Cobre Valley and could do the same for other rural hospitals facing financial crises.
Dialysis patients frequently have other medical needs, and now that they are staying in Globe, CEO Neal Jensen said, and so does the other medical services they require.
As the region’s CAH, the innovative partnership keeps care in the neighborhood, creating access to nephrology care within the community’s existing healthcare hub, their local hospital.
“They may need surgical intervention, they may need cardiac intervention…and so those service lines are doing better because we’re more efficient and more able to care,” Jensen said.
Sahani believes the partnership with Cobre Valley may be the only one of its kind in the country even as Jensen notes other rural hospitals, especially those in communities with a high prevalence of kidney disease, could certainly benefit from a partnership with Sahani and Desert Kidney Associates. All rural hospitals need, Sahani said, is “to buy the equipment—which is not too expensive—and have the willingness to train nurses and think outside the box.”
Jensen explains,
It makes a lot of sense. It’s actually far more successful than we ever dreamed of.
Learn More: DKA Chief Transformational & Relationship Officer Cynthia Gunnison (480) 262-6539 or PHS Managing Partner Jim Hammond (602) 679-4322.
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