Smaller, independent hospitals across the nation have increasingly sought partnerships with larger hospitals in recent years, a trend largely driven by financial challenges.

For Highlands-Cashiers Hospitals, the latest hospital in the region to jump on board with Mission Hospital in Asheville, cost savings were certainly a large motivator, although not the only one. While Highlands-Cashiers Hospital loses money on operations every year, that doesn’t mean it is in the red.

Highlands-Cashiers Hospital will soon join the growing number of small hospitals in Western North Carolina to come under the management of Mission Hospital in Asheville.

The hospitals in Jackson and Swain counties formally declared last week that they want out of the partnership forged nearly three years ago with Haywood’s hospital — however, it’s not at all clear whether the leaders of Haywood Regional Medical Center will agree to let them leave.

When Dr. Janine Keever hit the online shoe stores last month to hunt for the optimal pair of white knee-high platform boots, she wasn’t trying to spice up the look of her delivery room scrubs.

Instead, the retro footgear would be the perfect hallmark of her disco attire, donned in good fun and for a good cause during last weekend’s “That ‘70s Gala” fundraiser put on by the MedWest-Harris and Swain Foundation.

Count me among those who hope the MedWest affiliation between Haywood, Jackson and Swain hospitals survives. Otherwise, I fear none of the three hospitals will survive, but instead be swallowed up or severely marginalized in within a decade.

It’s been a tumultuous four years for the hospitals in the counties west of Buncombe. Despite the bumps in the road, though, there seems now at least a path — via the management contract with Carolinas HealthCare — for the three hospitals to move into the future serving pretty much the same role in their communities they’ve been serving for decades.

The county is looking to fill five open positions on MedWest-Haywood’s hospital authority board during a critical time when the MedWest system as a whole is trying to decide its future.

Growing discontent among some Jackson County doctors has the system — which includes MedWest-Harris, MedWest-Swain and MedWest-Haywood — questioning whether the three hospitals should continue on as one connected system, dissolve their partnership completely or simply loosen their bond.

Barbara Wells donned her fanciest scrubs last week — a cute flowered bandana and matching green top — for the grand opening of a new outpatient surgery center on the campus of MedWest-Haywood.

Whether it’s a mammogram, cataract surgery, hip replacement or dreaded colonoscopy, patients in Haywood County will no longer have to schlep through the hospital for simple same-day procedures.

The medical community in Jackson and Swain counties has renewed its call to part ways with Haywood Regional Medical Center less than three years after forging an alliance under the MedWest banner.

If you fall from a ledge rock-climbing, break a leg backpacking in the wilderness or twist your shoulder paddling a remote river, hope like hell that Robin Pope will happen by.

Rising health care costs were the catalyst for two budget decisions by Haywood County commissioners, one that will hopefully save taxpayer money and the other a stopgap measure to keep up with employee health insurance.

Commissioners were forced this week to pay an additional $150,000 into the health insurance fund for retired employees who are under 65 — twice what was budgeted.

Commissioners seemed surprised over the increase.

“Should we be concerned about this?” asked Commissioner Kirk Kirkpatrick. “We have a liability, and it is going up. It is more than twice the budgeted amount.”

The rise is due mostly to an increase in the number of retired workers under 65. When the county down-sized its work force during the recession, it offered early retirement options to workers under 65, and so the number of former employees in this category has now risen. The county only pays a portion of the health insurance for employees who retire before 65.

Stamey said the cost for retired employee health insurance would almost certainly continue to rise, however. The county also had to pay an additional $27,000 into the fund for employees over 65.

He hopes switching to almost exclusively generic drugs — unless a brand name is prescribed for medical reasons — could provide huge savings and is working on implementing that change.

Commissioners also voted unanimously to enter into a contract with Southern Health Partners to provide medical care for inmates at the county jail.

This fiscal year, the county will spend an estimated $230,000 on medical care for inmates, from dental work to prescription meds to doctor’s check-ups. By contracting out the lion’s share of inmate health care to a private firm, the county hopes to knock about $25,000 off its costs.

The contract with SHP is $134,888 a year but doesn’t cover everything. In addition to doctor and nurse visits, it only covers the first $30,000 in hospital visits, pharmaceuticals and specialist care. After that amount runs out, the county will be on the hook for whatever additional costs are incurred in those areas.

In addition to the contract with SHP, the county is budgeting another $70,000 for inmate medical care.

Commissioners still hope the contract can save a few dollars.

Haywood’s detention facility averages about 75 inmates a night, and the county is legally obligated to provide medical care for inmates under its watch.

While the coming year’s projected savings are modest, commissioners say the contract should help.

“We all hope this will reduce inmate healthcare costs and provide a solution to overall rising costs,” said Commission Chairman Mark Swanger.

— By Scott McLeod