Document Type

Article

Publication Date

2025

Abstract

Maine’s rural hospitals struggle with workforce shortages, high operating  costs, inadequate reimbursement, and patients bypassing their local hos pitals to access services outside of the community. Since 2013, four Maine  acute care hospitals have terminated inpatient operations. Evolving chal lenges include a declining need for inpatient beds, growth in Medicare  Advantage and value-based payment plans, escalating healthcare costs, and  the Reconciliation Act (HR 1), which contains provisions expected to harm ru ral hospitals, providers, and residents. To partially offset the anticipated neg ative impact of the bill, HR 1 also provides $50 billion in funding for a five-year  Rural Health Transformation Program (RHTP). This paper reimagines the role  of rural hospitals to focus on the delivery of comprehensive primary care  and essential services, proposes regionalizing services to maintain access  to care, discusses the role of the state in supporting rural hospitals and ap plying for RHTP funds, and offers a Rural Community Health Transformation  Collaborative model to engage communities in planning for and supporting  their local and regional hospitals and delivery systems.

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