Rural Hospitals Unite to Enhance Sustainability and Care Delivery

In North Dakota, a collaborative approach is transforming the future of rural healthcare. Instead of resorting to sale or closure, independent rural hospitals are forming strategic networks to share resources, negotiate better prices, and expand services—ensuring their communities continue to receive essential medical care. One such initiative, the Rough Rider Network, comprises 22 hospitals that leverage their combined patient populations to negotiate favorable contracts for mobile imaging units like an MRI truck. The mobile MRI visits smaller communities such as Bowman, eliminating the need for residents to undertake lengthy trips to distant hospitals, which can be costly and inconvenient.

These networks enable rural hospitals to retain their autonomy while gaining collective bargaining power, crucial in an environment where many small facilities face financial pressures. They also share specialized staff, invest in community health infrastructure like broadband and housing, and coordinate services such as telehealth and prescription programs. The formation of these networks was partly driven by recent legislation, including funding from the $50 billion Rural Health Transformation Program, aimed at bolstering rural health systems.

Experts highlight that these collaborations can improve patient outcomes while maintaining hospital independence, thus supporting local economies. Studies show that since 2010, over 150 rural hospitals have closed or ceased inpatient services, with many others merging with larger systems—sometimes leading to the loss of local control and services.

Advocates for rural health believe that such networks could serve as models for sustainable healthcare delivery. Leaders like Dennis Goebel, CEO of the Bowman hospital, emphasize that collaboration gives small hospitals a stronger negotiating position with vendors, leading to better pricing and service terms. Additionally, networks allow sharing of specialized medical professionals and investments in technology and community development, ultimately improving health outcomes.

Programs like the one led by Caret Health at St. Kateri Hospital illustrate how coordinated outreach can boost preventive care and reduce hospital costs. Patients receive multiple contacts encouraging them to undergo vital screenings and vaccinations, which results in tangible health and financial benefits.

For residents like Retta Jacobi, these innovations mean quicker access to diagnoses and treatments, often without expensive travel. Jacobi, who recently benefited from an MRI scan, expressed her support for local healthcare control, highlighting its importance for small towns.

While the effectiveness of these networks remains under continuous evaluation, initial evidence suggests they can help rural hospitals survive and thrive amidst ongoing financial and operational challenges.