Advancing rural healthcare

Published 1:25 pm Monday, November 21, 2022

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The 17th of this month was National Rural Health Day, so it feels like a wonderful time to talk about our work to advance rural healthcare here in Polk County and beyond. By nature of proximity, rural healthcare has long been the frontline for quick emergency response in many US communities. If you have a heart attack, a stroke, or have been in an accident, your life is on the line, and every second counts. If you live in rural Polk County, it may take an hour or more to get to a trauma center, but having St. Luke’s Hospital nearby gives you the best chance at survival due to the rapid initiation of care.


We in Polk County are fortunate to have a community hospital still. Unfortunately, many rural hospitals are losing money nationwide and struggling to survive. In the last ten years, more than one hundred thirty rural hospitals have closed, causing a loss of the emergency department and essential outpatient services in rural America. These closures increase the risk of death and disability when severe emergent medical conditions happen. The hospital shutdowns also increase health risks due to undiagnosed conditions and poor treatment because of the limited access to care. We never want to see this tragedy occur in our community.

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  • 25% of all US hospitals are small rural hospitals—25 beds or less
  • Only 2% of all national hospital spending goes to small rural hospitals. 
  • Most rural hospitals are the only source of hospital care in their community
  • Most rural hospitals are paid less by insurance plans than it costs them to provide services
  • Most urban hospitals are paid significantly more by insurance plans than it costs them to provide services
  • Most rural hospitals lose money, while most urban hospitals turn a profit
  • The median profit margin of rural hospitals before the pandemic was 2.3%
  • The median profit margin of urban hospitals before the pandemic was 35%
  • It costs more to deliver healthcare services in rural communities than in urban environments


There are substantial differences between small rural and large urban hospitals, presenting momentous consequences when writing federal and state policies that control spending on each. At issue is preserving equitable access to primary healthcare for people in rural America.




NRHA is a nonprofit organization working to improve the health and well-being of rural Americans and provides leadership on rural health issues through advocacy, communications, education, and research. NRHA’s membership is a diverse group of individuals and organizations from across the country, all of whom share an interest in rural health.


One of NRHA’s national leadership training initiatives is the NRHA Rural Health Fellows Program. This outreach is an intensive yearlong training program that educates and prepares a group of diverse healthcare leaders who can articulate a clear and compelling vision for rural America. 


Every year, NRHA names ten to fifteen highly energized people with a proven track record of dedication to improving healthcare throughout rural America. After an exhaustive review, the selection of seventeen fellows makes up the class of 2023. I am truly humbled to be among the 2023 Rural Health Fellows.


“We are very pleased to announce this new class of fellows as this program enters its seventeenth year. Once again, this class represents various levels of rural health expertise,” NRHA CEO Alan Morgan says. “With the successes achieved by the previous classes, we look forward to continuing the tradition of building rural healthcare leaders through this valuable program.” 


As a 2023 Rural Health Fellow, I will have the opportunity to bring greater awareness to work done at St Luke’s. In doing so, I hope to connect us through this national platform to additional grant opportunities and supporters to help advance our efforts here in Polk County. It’s essential work. Despite St. Luke’s being one of the top critical access hospitals in a 200-mile radius, the need to grow to serve our community more profoundly is pressing. We want to have the best care available for our citizens. 


Many of you have helped our hospital as we needed to raise funds for new equipment or start a new program, and through you, we saved lives. We want to keep that momentum moving forward. Educating you on the state of rural healthcare and the importance of our local hospital will encourage you to make your voices heard regarding the importance of rural healthcare in our county, state, and country to legislators and officials. I hope this will also encourage you to utilize our excellent community hospital and affiliated services whenever you need healthcare. Using the hospital is the best way to ensure that there is always a hospital in our county to serve our healthcare needs. 


If you have a healthcare topic of interest or want to learn more about St. Luke’s Hospital, send me a note at Also, please follow us on Facebook, Twitter, and LinkedIn, or visit our website at