From California’s Central Valley to the far northern border of our state, rural hospitals dot the health care landscape — and few understand their significance to the broader hospital field as deeply as Hospital Council and its members.
Earlier this week, Hospital Council joined our members at the California Hospital Association’s annual Rural Health Care Symposium for two days packed with the questions most pressing for hospital leaders:
- How might rural hospitals benefit from the state’s Rural Health Transformation Program funding?
- What tools can rural hospitals learn from each other to maximize scarce resources?
- When will impacts from 2025’s One Big Beautiful Bill Act (OBBBA) be felt, and how can rural hospitals prepare?
Some of these answers are more straightforward than others. With respect to the Rural Health Transformation Program, for example, the Centers for Medicare & Medicaid Services (CMS) has approved $183 million of California’s expected $233 million award. The remaining $50 million still being discussed relates to “transformation payments” that would support distressed hospitals (CMS has raised questions as to whether this amount exceeds the program’s 15% cap on direct provider payments). Once this is resolved, the state will formally announce the award and provide more details about planned projects and next steps, including a kick-off webinar for stakeholders in April and requests for applications expected in late spring.
Other answers are not so clear. While the biggest impacts from OBBBA aren’t likely to hit until 2027 and 2028, hospitals are already seeing declining Medi-Cal enrollment that will quickly lead to increased uncompensated care provided by hospitals.
This is why Hospital Council is deeply grateful to rural hospital leaders like Mary Casillas, CEO of Hazel Hawkins Hospital; Kevin Flanigan, MD, CEO of Southern Inyo Hospital; and Clint Purvance, MD, CEO of Barton Health; all of whom graciously offered their insights on a panel presentation during the symposium. Their insight on the issues that rural hospitals have faced, are facing now, and will likely face next year resonated with their fellow rural hospital leaders. Hearing firsthand how they’ve adapted to the evolving financial and organization challenges facing their hospitals and positioned their organizations for long-term sustainability gave me hope.
When a rural community loses its hospital, patients’ health care needs don’t disappear. They are just forced to travel farther and wait longer to have those needs met. All hospitals, not just those in rural areas, can learn from the lessons shared this week. The ripple effect of rural hospitals’ challenges is felt all the way into California’s urban core and protecting rural access to care helps all Californians lead healthier lives.