Win/win: urban and rural hospitals network for survival.

In an increasingly competitive, regulated, and politicized environment, the future of small or rural hospitals must rely on an organizational affiliation with an urban multihospital system to optimized opportunities for survival. Development and implementation of a small or rural hospital's affiliation with an urban multihospital system may provide necessary support and strength to survive as an independent entity, avoid mergers and acquisitions from investor-owned systems, and incorporate technical assistance and access to the resources of large, urban "lead" hospitals. Diversification into long-term and alternative care services will provide the foundation for hospital-wide survival through adaptation of alternative delivery plans to both the public and private sectors. Networking, whether through a formal or informal structure, may provide both urban and rural, large and small hospitals, with the only opportunity for survival in the 1980s and beyond. Networking gives hospitals an opportunity to develop symbiotic relationships with previously competing institutions for physicians, services, and patients. Networking solidifies missions, goals, and objectives for healthcare delivery systems and produces a win/win situation for everyone. It may be a legal entity (a corporate structure) or an informal affiliation among like groups of providers. A discussion of networking is provided for consideration by hospitals currently evaluating options in the multihospital systems arena.