Becker's Hospital Review

17 EXECUTIVE BRIEFING 2 EXECUTIVE BRIEFING 4. Make telehealth a 'force multiplier,' not a stopgap The clearest reframe is treating virtual care not as an emergency patch but as permanent infrastructure that augments a scarce workforce. Rural leaders are investing accordingly: in a Black Book Research survey 63% of rural and critical access hospital stakeholders said they were prioritizing telehealth and remote- monitoring expansion under the RHT Program. Dr. Gallagher described the payoff of telehealth investments as a "force multiplier." "If we're doing it right, we're hitting on all four at once," he said, referring to access, staff stability, outcomes and finances. The staffing relief is immediate; when a remote team covers the ICU every night, it can help eliminate the overnight coverage gap, and with it the late-night transfers it once forced. Virtual care can also extend the clinicians a hospital already has. Rather than replace a retiring specialist, virtual coverage can lighten the load enough to keep them on staff for years longer, according to Dr. Gallagher. With half the rural physician workforce over age 55, that kind of partial support is becoming essential. 5. Redesign and right-size the model, not just the staffing Stabilizing the workforce also means reenvisioning the model it staffs — keeping care local, matching services to demand and leaning on system affiliation, now common to 68% of U.S. hospitals. At Chicago-based CommonSpirit Health's Central Region, leaders are keeping recovery local. "We're expanding our use of swing bed programs across our critical access hospitals to create a more coordinated care model — reducing the length of stay at tertiary hospitals while allowing patients to recover closer to home," David Jones, critical access market president, told Becker's, citing a 25% year-over-year increase in swing bed days. At Troy (Ala.) Regional Medical Center, CEO Rick Smith has right- sized service lines to prioritize high-demand core services like emergency care and outpatient diagnostics while matching staffing to demand. The effort has improved operating margins, length of stay and throughput, he told Becker's. 6. Tame the red tape that flexibility creates Multi-site and virtual care coverage unlock flexibility, but they also pile on regulatory work that thinly staffed rural organizations struggle to absorb. The federal government is trying to ease that friction: CMS weighted participation in interstate licensure compacts when scoring states for RHT Program funding. The scale is daunting. A single physician practicing across state lines may juggle dozens of hospital privileges, multiple state licenses and payer enrollments — and Access TeleCare's roughly 800-clinician group processes some 1,200 hospital privileges and 200 state licenses a month. For rural hospitals, the practical answer is often a partner that absorbs the paperwork. "We take all that risk on ourselves," Dr. Gallagher said. "Our goal is to de-risk this and make this super complex process as simplistic as we possibly can for the hospitals, so that the burden is as light as possible for them." That extends to getting paid. Access TeleCare runs claim submission, denial management and payment posting for those encounters on athenahealth's revenue cycle technology — the back-office engine that keeps distributed, virtual-heavy care financially viable*. 7. Forge partnerships beyond your walls No rural system solves its workforce challenges alone, so the most durable strategies are increasingly collaborative. Named its state's center of excellence for rural healthcare development, the University of Tennessee Health Science Center uses state grants to lead rural training but sees partnership, not its own footprint, as the engine. "We can't do it by ourselves…we work with hospitals across the state," Raaj Kurapati, the center's executive vice chancellor and COO, told Becker's, describing efforts to extend those ties to rural hospitals and clinics. Others are scaling the pipeline itself. The University of New Mexico Health Sciences Center in Albuquerque is preparing to break ground on a new school of medicine designed to double its graduating class over the next decade — a project it has driven from concept to design in roughly two years, propelled by strong state support. That pace, said Rebecca Napier, its vice president of finance and administration, depends on partnership reaching well beyond the institution. "In order to be able to do this type of large-scale project in an area like this, at such a fast pace, it has become incredibly important to not just have that alignment internally, but also externally as well," she said. Reframing scarcity as operational discipline For all their variety, the seven strategies share a logic: each multiplies the reach of a finite workforce rather than simply adding to it. Culture and education pathways deepen the local talent pool; top-of-license teams, telehealth, care-model redesign and lighter administrative loads stretch the clinicians already in place, increasingly enabled by technology that strips out friction. Together, they reframe scarcity not as a ceiling but as a discipline. Technology is the quiet through line — the infrastructure a scarce, distributed workforce runs on. It's a role athenahealth fills across thousands of practices, rural and community health centers among them, and the revenue-cycle backbone behind Access TeleCare's model. For all the technology, the stakes remain human. "Do not give up on rural health. It is an incredibly important piece of the healthcare fabric," Dr. Gallagher said of rural areas. "It's a big deal for those 20% of Americans that live there — 60 million people. It's the size of France or England. It's a country upon itself. It's important that we're serious about making sure care stays open and available." athenahealth is curing complexity for ambulatory healthcare practices and their patients with intuitive AI-native technology and embedded services that improve clinical effectiveness, patient experience, and financial performance. athenahealth's vision is to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all. Learn more at www.athenahealth.com. Rural Healthcare Excellence in 2026 *These results reflect the experience of one particular practice and are not necessarily what every athenahealth client should expect.

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