What rural healthcare leaders need now

Note: This is an excerpt from the MEDITECH Blog. See the link at the end to read the full article.

The “One Big Beautiful Bill Act" (OBBBA) has been top of mind, especially for rural and community hospital leaders, since it was introduced. The bill particularly imperils their organizations, which already face incredibly thin margins. New reimbursement changes and tax restrictions could now prove fatal for care in smaller communities.

Supporting rural and community hospitals and the patients they serve has always been central to MEDITECH’s mission and values. We’ve been working hard to create tools and resources to help them not just survive, but thrive in this new paradigm — because strong, independent, locally-owned healthcare is not just important for these communities, but for our healthcare system as a whole.

Today we’re faced with a choice: We can either support and strengthen these organizations, or force them to merge with larger, urban and suburban healthcare systems. We believe the latter would be devastating to healthcare, both locally and nationally. Here’s why, and what we can do about it.

Less competition = less innovation, higher prices, and lower quality

Time and again, we see that reduced competition from consolidation results in reduced innovation. It also leads to lower quality products and services, and higher (not lower) costs. When cost savings do occur, they’re rarely passed on to consumers. In healthcare, that means both insurers and patients end up paying more.

A 2025 study from the Health Affairs journal showed that hospital mergers lead to price increases of 20 to 30 percent for patients. That means reduced affordability and accessibility. Moreover, data shows that most rural hospitals that merge end up with reduced services and poorer patient experience.

The importance of local care

There are additional impacts of consolidation that can’t be easily quantified. Rural healthcare organizations are a key pillar of their communities’ identities. There’s a sense of pride in smaller towns and rural areas in their own homegrown organizations. They don’t simply offer residents convenience, but trusted care by providers they know.

In an era marked by an erosion of trust in science and medicine, this kind of trust in local healthcare organizations and providers is vital. When smaller rural organizations are absorbed into larger urban ones, that trust is often further eroded.

What it will take to protect rural healthcare

To foster the kind of innovation rural healthcare organizations need to thrive as the impacts of the OBBBA take effect, we need a few key ingredients:

1. A fair and transparent distribution of Rural Health Transformation Program (RHTP) funds, based solely on needs and the merits of specific projects, not political influence.
2. A genuine commitment to interoperability, including an end to practices like information blocking and the enforcement of the rules TEFCA set via the Common Agreement.
3. Solutions tailored specifically to the rural health community, with robust, innovative functionality, not scaled-back solutions.

Regardless of the choices made around RHTP funding or the wider impacts of the OBBBA in the years to come, MEDITECH has always stood by rural and small community-based healthcare organizations — and that commitment won't change.