Keeping Rural Healthcare Local: The Power of Collaboration Without Consolidation

David Theobald • September 21, 2026

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Some of the most beautiful places in our country are rural.

As an Adirondack 46er, I have a real love for the mountains, rural landscapes and small communities found along the way. But living farther from a city should never mean living farther from lifesaving care.

Early in my career, I worked in rural healthcare as an ER nurse. I saw firsthand how important local hospitals are, especially for older adults, low-income families and other vulnerable populations. In an emergency, minutes matter, and so do miles.

Becker's recently reported that more than 150 independent rural hospitals across eight states have joined clinically integrated networks. By working together, these hospitals can strengthen payer negotiations, share technology and data, reduce costs and expand access while maintaining local governance.

This opportunity should not end with those eight states. Independent hospitals serving rural communities throughout the country could potentially benefit from similar collaboration.

Rural hospitals should not have to give up their independence to gain the benefits of scale.

Could this model strengthen healthcare across other rural parts of the country? I believe it is a conversation worth having.

References

U.S. Government Accountability Office — "Why Health Care Is Harder to Access in Rural America"

Health Resources and Services Administration — Rural Health

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