Three practical steps to strengthen financial performance

Each day, rural health care administrators make high-stakes decisions that impact their organizations and communities. Leaders must balance staffing constraints, tightening margins, and increasing industry complexity while working to maintain access to essential care.

For most rural organizations, this level of analysis is difficult to build internally. The practical answer may be shared resources, peer collaboratives, association support, or outside expertise that can help translate raw transparency data into market-specific insight. The goal is not more reporting. It is a clearer foundation for decisions around access, pricing, and long-term stability.

Why this matters now

Recent national analysis found that over 400 rural hospitals – about one in five nationwide – are vulnerable to closure, while more than 40 percent are operating at a loss. By the time a pattern appears in denials, payer performance, or service-line demand, the window to act proactively may already have narrowed.

These decisions are not just operational. They determine whether patients can access care locally, whether providers can sustain services, and if rural communities retain critical health care infrastructure.

A model for rural resilience

In my experience as a physician and informaticist, top health care organizations improve performance by following a proven, strategic approach: understand, analyze, plan, and act. Rural health care leaders can take these steps now to make better-informed, proactive decisions that strengthen outcomes for their communities and organization.

Understand your market dynamics

Price transparency data has created the potential to better understand market signals and inform decision-making. However, these datasets are large, inconsistent, and difficult to interpret. On their own, they don’t clarify where the real opportunities are or what action to take next. This is where many organizations get stuck and why rural health care organizations must invest in new ways to understand the data.

To make raw transparency data valuable, it needs to be clean and interpreted within the context of your market. How do your rates compare? Where does variation exist? What is the data signaling about demand and performance?

For most rural organizations, this level of analysis isn’t feasible to build internally. As a result, many are turning to external partners who can bring both the data and domain expertise required to translate transparency data into meaningful, market-specific insight. When that happens, the conversation shifts, bringing clarity and a stronger foundation for decisions around access, pricing, and long-term stability.

Analyze opportunities

For many rural health care leaders, decisions about expanding a service line are already on the table. The challenge is making those decisions without a clear view of where patient leakage is occurring, what true demand looks like, or how reimbursement rates compare within the region. Without a baseline analysis, decisions can be inaccurate, delayed, or reactive. In rural health care, this scenario is common and the cost of making the wrong decision is real.

Analyzing the data reveals where you can improve access to care in your community while generating sustainable revenue for your organization. Scenario modeling can help estimate the volume, staffing, and revenue impact of a service-line decision using local population, utilization, and market trends. The goal isn’t simply to create volume or improve margins. It’s to make deliberate decisions based on clinical need, community demand, and economic reality.

Plan and act earlier, with confidence

Once you understand the data and analyze your market for opportunities, you can confidently plan and act on the focused initiatives that will have the biggest impact. This approach is more targeted than attempting to act on every opportunity or solve everything at once. You just need a willingness to move forward and adjust along the way.

Even small changes can have meaningful outcomes, whether that’s negotiating fair rates with payers based on peer benchmarking, adding a new service line, or expanding capacity for existing care to meet community needs. This is where you will find the intersection of doing what’s right for your community while ensuring the financial stability needed to keep hospital doors open.

Rural care in action: New River Health Association spotlight

A great example of meeting a specific population’s needs is displayed in West Virginia at the New River Health Association.

“One of the things we have a problem within our area of West Virginia is access to care,” says Lisa Emery, a registered respiratory therapist and director of the breathing center at New River Health Association. “We are definitely in a health care desert, and some patients must travel a very long way on roads that are not easy. By offering a wide range of service lines, from primary care to gynecology to vision care, patients can see multiple clinicians in one day. That is important for our community.”

This community has a high demand for pulmonary therapy services due to elevated rates of lung disease in the state and a large coal miner workforce. Recognizing both the clinical need and the opportunity to expand access locally, Emery secured a rural health grant to support the initial investment in workforce capacity.  That investment helped expand patient access while supporting a more sustainable service model over time.

“We are a high-volume clinic, and we needed help expanding capacity of this specialty care,” Emery says. “By adding a third therapist, we were able to see over 800 additional patients in a year. We educate and empower this population to get healthier, which reduces our hospital readmission rates. And it’s making a real impact on our community.”

The path forward for sustainable care

Rural health care systems are already operating lean, with little room to absorb inefficiency or delay. The time to shift from reactive to proactive decision-making is now. This approach is not theoretical, and it is not easy. But it is necessary, possible, and actionable.

Understand the data. Analyze the opportunities. Plan and act on the few initiatives most likely to protect access and financial sustainability. That is how rural organizations can continue serving their communities for years to come.

NRHA adapted the above piece from Claritev, a trusted NRHA partner, for publication within the Association’s Rural Health Voices blog.
 

As Claritev’s chief medical officer and chief product officer, Jigar Patel, M.D. oversees the innovation and solutions lifecycle team, providing medical expertise in all areas of the company with a focus on the strategic development of Claritev’s health care technology products and solutions. Dr. Patel has deep expertise in health care delivery, medical network dynamics and industry relationships.