No. 154: Rural Hospitals

We're talking about clinically integrated networks this week, a way for rural hospitals to band together to improve patient care and lower costs without joining larger health systems. It's a microcosm of a broader challenge facing local, community-minded businesses: how do you compete with the major players when you're not big enough to get the same economies of scale or buying power? For these hospitals, the answer is partnership.

Speaking of better healthcare, our featured job this week centers on vision health. You're probably familiar with the company, but you might be surprised to learn about their social impact chops. I'm also sharing a mentorship opportunity specifically focused on helping young women reach their goals, whether you want to meet in person or participate in "flash mentorship" through the organization's mobile app. It's pretty slick, and I'd love to see their impact grow.

~ Greg

What we're reading

Small-town hospitals are forming alliances to pool resources and retain local autonomy without sacrificing quality healthcare or selling to large regional or national health systems. (NPR)

• The concept is called a "clinically integrated network", and it allows rural facilities to pool resources without sacrificing community ownership.
  • For example, North Dakota hospitals share costs for expensive equipment like mobile MRI units that would be prohibitively expensive for a single rural hospital.
  • Clinically integrated networks can also negotiate better rates with insurers by combining patient rolls, giving hospitals more buying power than they'd have if they tried to negotiate alone.
• The model addresses a stark reality facing rural America: since 2010, 153 rural hospitals have closed or stopped offering inpatient services while 441 others merged with or were acquired by larger systems.
  • When these types of hospitals are acquired, it's not just a matter of joining the system and everything stays the same: mergers often lead to service cuts and staff reductions in rural areas where facilities serve as major employers because the larger system can centralize functions that a local hospital might have retained onsite.
• I'm curious whether this collaborative approach could serve as a template for other essential rural services – take banking for example, or education where teachers are even harder to come by in isolated areas – that face similar pressures to consolidate or disappear.
  • You could look at the corporate world more generally and how the big players tend to squeeze the little players through economies of scale. How do you become as efficient as a corporation with far more resources?
  • In this case, the answer is partnership. It may be a bit messy or inefficient relative to centralized governance, but there's strength in numbers.
  • I'm reminded of the Transformational Resilience Coordinating Network concept from a few months ago: a very different problem set, but a similar idea of pooling resources to support local communities.

Job of the week

I might be biased for featuring Warby Parker because I've purchased a few pairs of their glasses in the past, but did you know they're also a public benefit corporation with an associated foundation focused on expanding vision care? They've been operating a Buy a Pair, Give a Pair program since 2010 and have since grown to offer vision screenings and eye exams for students in the United States.

As you can tell, I'm a fan of the mission – but more to the point of this newsletter, they have a reliable source of job opportunities at their stores around the country and a handful of corporate roles. This week, I'm pointing you to a Product Manager role in their New York office with reasonable job requirements. If you're more of a Senior Product Manager type, they've got you covered there as well. You can find the full list of openings on their career page.

Community roundup

• Eli Lilly's weight loss pill has succeeded in another late-stage trial, which puts the company on a path to file for drug approval. (CNBC)
  • This is essentially a pill version of the GLP-1 injections that have grown exceedingly popular over the past few years. Around one in eight adults takes one.
  • Injections are still off-putting to a lot of people, so this pill is viewed as something as a breakthrough for making the treatment more accessible.
• The impending loss of the electric vehicle credit has supercharged year-over-year sales. EVs made up 12.8% of sales in August compared to 3.2% last year, but this is expected to drop considerably once the tax credit goes away. (Grist)
  • I recently purchased my first EV – no tax credit for me, unfortunately – and I've been very impressed so far. The used market is especially ripe for action since depreciation is high.
• The U.S. Energy Information Administration reported that renewable energy sources hit a new record last year, producing 28% of the country's electricity. (Electrek)
• Hurricane Katrina not only decimated homes but led to the firing of over 4,000 teachers, most of whom were Black women. (The Guardian)
  • Since then, multiple organizations like Black Education for New Orleans and InspireNola have been formed to recapture that demographic makeup and its impact on students, for whom having a teacher with the same racial identity increases the chance they graduate from high school.

Civic corner

• Lots of health-related news this week, and we'll start with vaccines: Washington, Oregon, and California have formed a health alliance that plans to offer its own vaccine recommendations amidst turmoil at the Centers for Disease Control, where a high-profile firing over vaccine oversight led to walkouts. (NYT)
• On the opposite end of the spectrum, Florida has positioned itself to become the first state without vaccine mandates for students. (NYT)
  • I wouldn't be surprised to see a state like Texas follow suit. They've been neck and neck on health-related announcements, like removing fluoride from drinking water.
  • I do wonder how it will play in a state that recently saw its largest ever measles outbreak, and that outbreak spread across state lines.
• The government has been systematically removing content from websites to comply with various executive orders on climate change, public health, and diversity, equity, and inclusion. This week, the Trump administration agreed to restore public health webpages as part of a court settlement. (Axios)
  • One of the organizations behind the suit, AcademyHealth, noted that they also sued the Biden administration for removing Medicare data. Presumably that precedent played in a role in the outcome of this case.
• Last week I wrote about how Revolution Wind, a wind farm nearing completion in the Northeast, was halted by the Trump administration over national security concerns. Revolution Wind received approval from the Defense Department in 2023 for modifications designed to limit the impact on military radar. (NYT)
  • This week, it became clear that the administration's engagement to kill wind energy was more widespread than previously thought: not only is the Department of Defense involved, but the Department of Health and Human Services is investigating whether wind turbines emit electromagnetic energy, and the Environmental Protection Agency's Lee Zeldin is involved in high-level talks.
  • For reference, Revolution Wind was put on hold by the Department of Transportation. According to the Times, at least a half-dozen agencies are now involved in efforts to halt offshore wind projects.

Hot job opportunities

• Business Development Associate/Jr. Account Executive (Hybrid) – Pyka – Alameda, CA
• Customer Service Representative – GFL Environmental – Indianapolis, IN
• Digital Marketing Associate – Apollo – New York, NY
• Transporation Supervisor – Clean Earth – Pasadena, CA
• Creative Director - Art Director/Design – Thesis – Portland, OR
• Business Development Associate – Venture Solar – Brooklyn, NY
• Head of Brand and Communications – Intersect – Location
• Operational Asset Manager – Pivot Energy – Denver, CO
• Data Engineering Manager – Aerofarms – Remote
• Environmental Laboratory Technical Manager – KETOS – Sunnyvale, CA

Resource of the week

If you're looking for a way to make a tangible difference in a young person's life, you'll dig the mentorship programs at Step Up, a nonprofit that guides young women to meet their goals through flash mentorship and structured coaching.

They offer ways to connect in person and online, including through their mentorship app. For in-person mentorship, Step Up operates in Atlanta, Chicago, Dallas, Houston, Los Angeles, Nashville, New York, and the San Francisco Bay Area. If you've got career wisdom to share and want to help close the opportunity gap, this could be your chance to lift someone up – you don't need coaching experience, just good listening skills and a desire to make a difference.

Check out the Mentor Toolkit on their website to learn more about the program, how to participate, and some of the frequently asked questions. Even if you don't want to participate in Step Up explicitly, I thought the toolkit had some great advice for how to be an effective mentor in general.

Test your knowledge

Last week, I asked you about the term "food desert" and what it means. It's an indication that you live in an area where it's difficult to get food, often in the context of healthy, affordable food.

It tends to be more of an issue in rural areas, but if you have ever moved to different regions of the country, you got a taste of this on a micro scale: certain types of produce and meats can be near impossible to find outside of a specialty store, if at all. Food deserts aren't just a supply chain issue: it can be a function of distance to a grocery store, your access to transportation, or your ability to afford food.

Let's leave the "desert" and turn towards the oceans: they're getting warmer, and corals are taking the hit. Can you guess how much of our coral reef area has been affected?

In the current coral bleaching event, roughly what percentage of the world's coral reef area has been impacted by heat stress: 35%, 60%, or 85%?

Email me your guess, and I'll send one lucky winner a couple of One Work stickers!

I don't know about you, but I did a lot of cooking this weekend. We went all out with a taco bar, top-shelf margaritas, and Corona – and lucky me, I'm eating tacos all week.