45 EXECUTIVE BRIEFING
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EXECUTIVE BRIEFING
Some organizations are stepping in to fill the void, deploying
community-based models that bring services closer to where
patients live. Mobile health clinics, school-based programs and
post-acute services — including partnerships with local health
departments and post-discharge coordination — are expanding
access to preventive care without requiring lengthy travel.
Pittsburgh-based Allegheny Health Network deployed a mobile
MRI unit serving rural Pennsylvania, allowing patients to receive
advanced diagnostics at rotating community sites rather than
driving hours to urban imaging centers. Essentia Health (Duluth,
Minn.) redesigned oncology delivery through a hub-and-spoke
network, with central hubs offering surgical care and advanced
therapies while smaller community sites provide imaging and
infusion services.
"Our patients receive the vast majority of their care in their
own communities, where they have the social support critical
to navigating their cancer journey," said Lloyd Ketchum, MD,
hematologist, oncologist and division chair of cancer services
at Essentia.
4. Recalibrate service lines around what rural
hospitals can sustainably deliver
Many rural hospitals are reassessing which services they can
realistically sustain. For some, that has meant converting to the rural
emergency hospital designation — a model that allows struggling
facilities to preserve emergency and outpatient services while
discontinuing inpatient care.
Shawn Bright, CEO of Crittenden Community Hospital in Marion,
Ky., told Becker's the transition has created financial stability after
years of operating pressure, with the hospital now expecting a
positive margin in 2026.
Other rural organizations are taking a different approach: one
focused on carefully expanding the services they believe can
be sustainably delivered locally. Roosevelt General Hospital in
Portales, N.M., recently added surgical subspecialties including
orthopedics, urology and cardiology on a limited schedule, while
also purchasing a building to expand primary care under a rural
health clinic designation — a move CEO Kaye Green said will
support local access while generating referrals to the specialty
services the hospital is building out.
5. Make health data fluid across rural care
networks to enhance coordination
As care expands across hospitals, clinics, mobile services and
virtual visits, seamless data exchange has become essential. But
many rural providers still lag behind: According to a Black Book
Research report, 81% cite financial limitations as the primary
barrier to IT modernization; 67% face interoperability challenges
tied to legacy systems; and only 42% of critical access hospitals are
connected to a regional or national health information exchange.
Mr. Ganley said solving that challenge requires a fundamental shift
in how healthcare data moves across the system. "If you think about
transitioning healthcare to something we do rather than a place we
go, that shift requires greater liquidity of health data," he said.
Federal initiatives are beginning to accelerate progress, as CMS
launched a $50 billion Rural Health Transformation Program aimed
at upgrading infrastructure. Early planning shows many rural
hospitals plan to use these funds to modernize health IT systems,
strengthen cybersecurity and expand telehealth and remote
monitoring capabilities — investments leaders say are essential to
sustaining rural access in the years ahead.
For smaller and independent rural providers, the stakes are
especially high. Fragmented data not only complicates care
coordination, it widens the gap between well-resourced health
systems and the community practices patients depend on most.
Mr. Ganley underscored seamless data-sharing as essential.
"Interoperability is a playing-field leveler for ambulatory
practices," he said.
6. Leverage AI and automation to sustain
operations under workforce constraints
If interoperability helps rural providers access the right information,
automation may help them operate more sustainably.
AI is emerging as a powerful tool for addressing administrative
complexity. For small rural teams, time spent on documentation,
billing and compliance can consume a significant portion
of staff capacity. "If AI and technology can eliminate most of
that administrative work, that is wildly advantageous for those
practices," Mr. Ganley said.
Automation tools are already helping rural providers streamline
clinical documentation, improve patient outreach and expand
behavioral health access. At Avera Health in Sioux Falls, S.D.,
ambient listening technology has been implemented across its
clinics — after one year, 63% of physicians reported higher job
satisfaction and the technology reduced their cognitive burden
by 51%, president and CEO James Dover told the "Becker's
Healthcare Podcast."
"I believe AI will do to data and health information what the internet
did to how we communicate with each other," Mr. Dover said.
Do more with less — and a call to action
The pressures facing rural healthcare are unlikely to ease anytime
soon. But across the country, rural leaders are responding not
by expanding hospital infrastructure, but by redesigning how
care is delivered. Virtual-first models, community-based sites,
interoperable data systems and AI-driven automation are helping
organizations stretch limited resources while keeping care
closer to home.
For Mr. Ganley, the path forward requires both strategic and
operational discipline. "You've got to leverage technology and
streamline with AI everywhere you can," he said. "You've got to
position yourself as the primary care provider of choice for your
community, and you've got to think about how you transition into
value-based care models that can sustain the practice over time."
For rural providers, the future may depend less on expanding
physical infrastructure and more on building smarter, more
connected systems of care that extend high-quality care wherever
patients need it.
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Rural Healthcare Excellence in 2026
