Beyond the Bill: Shaping Rural Hospitals’ Future Through Strategy 

By Julie Amor, MHA 
Chief Strategy Officer, Onspire Health Marketing 

A $50 billion Rural Health Transformation Fund  has been unveiled – a high-dollar response to an even higher-stakes reality: Rural hospitals are under increasing strain. 

The fund, created through the recently passed One Big Beautiful Bill, was designed to soften the impact of Medicaid and Medicare reimbursement cuts. While we all welcome the intent, I believe we need to be candid about what this moment truly requires: 

 
This is a readiness moment – a chance for rural hospitals to step forward with strategic vision and a clear path forward. Because funding will be there, but access will not be equal.  

The program will distribute $10 billion annually from 2026 to 2030. Each year, half of that $10 billion will be distributed evenly to states with approved plans (translation: states with only a few rural hospitals will receive the same amount as states with dozens of rural hospitals). How the other $5 bill/year is distributed will be up to CMS discretion based on rural population, provider counts, and “any other factors the administrator determines appropriate.”  

Knowing this, it’s easy to predict that states and hospital systems with strong strategic plans, clear priorities, and aligned partnerships will be best positioned to meet the moment (the readiness moment) for short-term and long-term sustainability and success. 

As someone who has led strategic planning and marketing for hospitals for more than three decades, I say that not as a warning, but as a call to action. 

Kansas as a Case in Point 

Kansas offers a compelling example because the challenges and potential solutions are playing out in real time. We spoke recently with Cindy Samuelson of the Kansas Hospital Association, who reflected on both the opportunities and the work ahead: 

“Our members are excited… and we’re pleased that Senator Moran helped improve the amount of funding,” Samuelson said. “It won’t replace the losses entirely, but there’s potential for more support. We’ve got time to advocate and shape how this funding impacts our hospitals, and that’s critical.” 

Samuelson also noted that Kansas hospitals are already working with the Kansas Department of Health and Environment (KDHE) to help shape the state’s application, ensuring the voices of Kansas providers are at the table. That kind of engagement is exactly what this moment demands. 

It’s About Strategy, Not Just Survival 

Yes, many hospitals are still recovering from years of financial uncertainty. According to KHA, Medicaid only reimburses 65 percent of actual hospital costs, and Medicare about 69 percent. Those numbers are significant, so this isn’t a moment to play defense. It’s a moment to plan forward. 

Without clear, future-focused strategies, there’s a real risk that the communities with the greatest need will be the ones left behind when funding and resources fall short. Some of the most promising strategies we’re seeing include: 

• Donor and community fundraising campaigns that engage the public in rural health as a shared responsibility 

• Primary care and targeted service line growth – especially surgery, infusion, and outpatient specialties – aligned to the services most needed to keep each respective community healthy 

• Physician and APP recruitment strategies that double as brand platforms 

• Medicaid enrollment support programs to help patients keep coverage amid more frequent redetermination requirements 

• Creative approaches to non-operating revenue, including grant writing, tax support, and philanthropic partnerships 

Think of these as strategic building blocks. Sure, they may look different in Kansas than in Kentucky or California, but that’s the point. Each hospital’s plan must reflect its own data, its own voice, and the realities of its community. 

This Fund Can Be Transformative, If You’re Ready 

While experts like Cindy Samuelson and others advise that the Rural Health Transformation Fund won’t offset the lower reimbursements entirely, it can support departments like OB, mental health, emergency care, and other essential services that may not be profitable but are foundational to a healthy community.  

That’s where strategy matters most. As a rural health strategy firm (not just a branding partner), we work side-by-side with rural health and critical access hospital leaders to: 

• Define their voice and value in clear, credible terms 

• Align their transformation priorities with CMS criteria 

• Build momentum around the initiatives that matter most to their future 

We’ve helped hospitals recruit, rebuild trust, and launch campaigns that capture hearts and minds – and we are ready to support this next chapter. 

This Is Where Policy Meets Community 

At Onspire Health Marketing, we believe wholeheartedly in the strength and resilience of rural hospitals. We see what they make possible every day, and we support them with smart, accessible marketing strategies and tactics. While the transformation fund may be temporary, the impact of smart, data-driven strategic planning should be long-lasting – and it will be, if it’s handled well.  

That’s why this is a pivotal point, one that will distinguish the perils of “hope it works out” from the merits and “here’s our plan.” If you’re a rural hospital leader, are you ready to meet the moment? Let’s work collaboratively to ensure your hospital is well-positioned to help shape a brighter future for your community.  

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About the Author 

Julie Amor, MHA, Chief Strategy Officer for Onspire Health Marketing, has 35+ years of experience elevating hospital and healthcare brands. An architect of strategy with a proven record in leading strategic growth initiatives, she spearheads our strategy-first approach for hospital marketing, including our industry-leading rural health division. To discuss how we can partner with you to accelerate intelligent growth for your hospital or healthcare organization, contact Julie at 816-595-6723 or jamor@onspirehm.com.