Improving Rural Healthcare by Creating Academic- and Nonacademic-Rural Hospital Partnerships Based on Community Health Needs Assessments and Technological Needs

Over the past 14 years, 149 rural hospitals (comprising 6% of all rural hospitals) have closed or no longer provide inpatient services because of financial distress, staff shortages, and resource constraints.¹ In addition, more than 20% of rural hospitals are currently at risk of closing.² Nearly every state has rural hospitals at risk,³ and many rural facilities are cutting services to stay afloat.⁴ These closures and service restrictions reduce access to essential healthcare for underserved communities, many of which already face higher health risks and geographic isolation. Rural hospitals are critical for local economies and provide vital emergency care, making their closures a significant public health and economic concern.⁵ To survive, rural clinics and hospitals need to remain relevant to their service populations, demonstrate value, and remain technologically current. While the White House has recently launched an admirable initiative to support cybersecurity in rural hospitals,⁶ ecosystem transformation could better address the broader challenges needed to create sustainable partnerships between rural and urban healthcare systems.⁷ Without significant changes to reimbursement policies, financial pressures on rural hospitals will persist. Although critical access hospitals have a unique Medicare payment system designed to support their survival,⁸ these financial challenges will continue to hinder their ability to attract and retain an adequate workforce, invest in new technologies, and serve their communities.