In North Carolina’s 80 rural counties, health systems and hospitals help residents to get the care they need close to home.

Five healthcare leaders came together in a virtual town hall to discuss how they are reimagining rural health in North Carolina. This conversation is part of a series of virtual town halls hosted by the North Carolina Healthcare Association.

Here are some key takeaways from the conversation: 

Hospitals play a vital role in rural communities  

In North Carolina’s 80 rural counties, hospitals and health systems provide access to care close to home, advance innovation and invest new resources in their communities. They do more than just provide healthcare services — hospitals are part of their communities and collaborate to address social determinates affecting health like food insecurity, transportation access and other societal issues. 

Jessie Tucker, President and CEO of UNC Health Wayne, said that his hospital serves as an anchor for the community. They are the third largest employer in the county, next to agriculture and the local Air Force base. Tucker expressed that the decisions his hospital makes can attract larger employers and impact overall growth throughout the community. 

“Hospitals are the lifeblood of our communities,” said Tucker. 

Lynda Stanley, President and CEO of Dosher Memorial Hospital also discussed the important relationship between rural hospitals and their surrounding communities. Whether it is by attending events, visiting churches, or serving on boards, residents expect their local hospital to not only provide high-quality health care, but also to be part of the community. 

Medicaid expansion will be a lifeline for rural communities 

The recent passing of Medicaid expansion in North Carolina will provide health care coverage to the more than 600,000 North Carolinians who are currently in the coverage gap. Many of these people reside in rural areas, so this legislation will be particularly impactful in those communities. 

Kathy Bailey, President and CEO of UNC Health Blue Ridge expressed that although there is the necessary infrastructure to care for the people in her community, many of them cannot afford to seek care. Medicaid expansion will play a vital role in ensuring these people can receive the care they need. 

“Medicaid expansion will go a long way toward families being able to go to the doctor, go to urgent care, seek care where it’s appropriate, and then be able to pay for it,” said Bailey. 

Michelle Fortune, CEO of St. Luke’s Hospital mentioned that the reduction in uncompensated care will have a particularly important impact on rural hospitals. She also reiterated that this landmark legislation should be celebrated and that it will be vital to help hospitals, especially those in rural communities, serve those who cannot afford care. 

Building a strong rural healthcare workforce is essential

Recruiting and retaining a strong workforce in rural areas is essential, especially at a time when hospitals are critically short-staffed. Inspiring students to join the healthcare field and focus their careers in rural communities is key to creating a strong, sustainable workforce for rural hospitals. 

Brian Floyd, President of ECU Health Medical Center and COO of ECU Health talked about the importance of education and how training residents of rural communities to work in health care can lift people out of poverty, strengthen the workforce and drive future economic growth.  

“The role that hospitals and health care systems play, especially in rural communities, is incredibly important to the future of families, generation after generation, in those areas,” said Floyd. 

One of the best strategies to support the healthcare workforce is by “growing your own”, according to Stanley. She says that it is important to start early by engaging students in healthcare related careers while they are still in middle and high school.  

“[It is important to] get those students engaged early to help them understand what role they can play in healthcare,” said Stanley. 

In response to how communities can get involved in creating a stronger healthcare workforce, Fortune said, “every person listening to this panel should be an ambassador for the importance of rural healthcare…educating our communities, legislators and the next generation about why this work is meaningful and why it matters is so important.” 

Innovation is key to the success of rural communities  

Rural communities can provide opportunities to try new approaches and new projects to improve patient care and experience.  

Bailey explained the COVID-19 pandemic provided an opportunity to launch a virtual hospital at UNC Health Blue Ridge. She said within eight days, they implemented a system to provide care at home for some patients, while keeping hospital beds open for more critical patients.  Between 2020 and 2022, UNC Health Blue Ridge cared for 12,000 patients virtually. Bailey credits the nimble implementation of the project to the hospital’s position in a rural community in western North Carolina. 

“If we had been a large urban center, I don’t know that we could have taken that idea to implementation in eight days,” Bailey said.  

At Dosher Memorial Hospital, Stanley detailed an innovative partnership with local churches in minority communities. Churches and other houses of worship can be safe spaces. Providing telehealth visits there can be more accessible and less intimidating. Dosher Memorial Hospital also provided health education to the public using this same system.  

“I think what we can all say is that at the end of the day COVID taught us a lot. It showed us what we really can do under pressure, and I think that’s something we don’t want to forget,” Stanley said.  

Community partnerships make rural hospitals stronger 

To build innovative approaches, collaboration is sometimes necessary. Joining forces can create a wider pool of resources and reach deeper into the communities served.  

Tucker said a county-wide collaboration created WATCH, or Wayne Action Teams for Community Health. UNC Health Wayne, the Duke Endowment Fund, the Kate B. Reynolds Charitable Trust and other organizations joined together to support this initiative.  

WATCH, a health and wellness project, provides a mobile clinic that travels to uninsured areas of Wayne County to perform point-of-care testing on community members. Another WATCH unit visits the local YMCA to provide health education for the public, and a third unit is stationed at the hospital to support emergency department visits.  

“We’re very happy of the results that we’re getting from that that work, and we hope in the future with Medicaid expansion that the that unit could actually help us with enrollment as well,” said Tucker. 

In addition, ECU Health seeks out opportunities for partnership based on the needs of the communities it serves. Floyd mentioned the health system conducts regional community health assessments. If the findings show a large swath of counties are experiencing the same issue, there may be a need for investment to address the common issue, as well as runoff issues. This approach encouraged ECU Health to build a behavioral health hospital in response to the growing need and lack of resources in Eastern North Carolina.