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POV: The power of rural and driving change

The A&M Rural and Community Health Institute and Center for Optimizing Rural Health are proud partners in driving change for rural hospitals and communities
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Rural hospitals are more than health care providers to residents and surrounding communities. They are economic catalysts for their entire region, not only through the services they offer but also through significant employee bases that drive demand for schools, housing, transportation and other vital services. Hospitals are often the largest employer and a significant community partner. They serve as an anchor for both the local workforce and community-based initiatives focused on maintaining economic viability to support an ideal quality of life. Despite the major role they play in economic stability for their community, rural hospitals continue to struggle to keep their doors open.

A recent study from the Center for Healthcare Quality and Payment Reform reports that at least 40 percent of rural U.S. hospitals are at risk of closing their doors, potentially impacting health care access for the more than 38 million Americans residing in and around these rural hospitals. In addition to these troubling projections, rural populations experience higher rates of poverty, shorter life expectancy and higher mortality. Access to care and overall community wellness is a co-dependent relationship that is easily upset.

The A&M Rural and Community Health Institute (ARCHI), a component of Texas A&M Health, recognizes the vulnerable balance between access to health care for rural communities and community viability. For more than 20 years, ARCHI has worked with rural hospitals and communities, and with national, state and local rural advocates, to support the needs of rural health systems. In 2018, ARCHI expanded their rural-centric mission through the establishment of a Health Resources and Services Administration-funded technical assistance center, known as the Center for Optimizing Rural Health (CORH). The primary goal of CORH is to support rural hospitals and communities in their efforts to locally sustain critical health care services. To date, they have done that with more than 200 rural hospitals nationwide.

CORH supports rural hospitals through dedicated case management and coordination of resources that may have previously been unattainable due to cost. Taking to heart the rural adage “if you have seen one rural hospital, you have seen one rural hospital,” and the uniqueness of rural environments, CORH places a strong focus on identifying and addressing a hospital’s specific challenges through individualized action planning. Resources available to participating hospitals includes consultative services, access to subject matter experts, peer support, and education and training on topics relative to hospital management. Commonly requested areas of support include service line implementation, financial management, workforce training, and strategic and operational planning.

Rural health care systems have long been tasked with “doing more with less.” This was evident as the almost 1,800 rural hospitals that populate small towns, farming communities and frontier areas across America navigated the resulting challenges associated with COVID-19, from managing care to preventing spread. CORH shifted its technical support towards quickly identifying and providing resources to address the new challenges hospitals faced because of COVID-19, including providing access to industry experts on topics related to managing care, facility layout, and vaccine requirements and campaigns.

Post-pandemic, CORH continues to help fill in the gaps and serves as a link between hospitals and resources to address specific rural health system needs. Many rural hospitals continue to feel the financial strain from pre-pandemic operations that include low patient volume, decreased service lines, a reduced workforce, and ever-changing payor models. These challenges are the focus of multiple federal initiatives; however, they lack the concrete certainty of success and are not quick fixes. Through one-on-one interactions and customized strategies developed in partnership with small, rural hospitals, CORH shares subject matter expertise as well as grassroots innovation and lessons learned.

Community engagement and perception of local rural health care systems is an example of one area that CORH works closely with hospitals to address. Rural hospitals, which have a much smaller patient base than their urban counterparts, are heavily dependent on community support to maintain operations. Patients living in rural communities often bypass local health care for larger hospitals due to the belief that local health care is substandard, or that specialty care is not available. Word of mouth is an especially powerful vehicle for sending information, especially in rural areas where “everyone knows everyone,” and this can positively or negatively impact the frequency and manner in which local patients utilize services.  CORH can provide a multi-tiered resource approach to assist hospitals with this initiative that consists of marketing support, education, and best practice recommendations related to improving hospital culture and patient satisfaction, community education and information sharing, and how to maximize positive patient experiences to entice patients to return.

The A&M Rural and Community Health Institute and Center for Optimizing Rural Health are proud partners in driving change for rural hospitals and communities and stand behind the #PowerOfRural. If you would like to know more about the work at the A&M Rural and Community Health Institute, and the Center for Optimizing Rural Health, please contact us at, or visit

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