Rural health news has been increasingly unpredictable in recent years. At the announcement of the One Big Beautiful Bill, experts predicted dire consequences for rural health and the threat of pushing hundreds of struggling hospitals closer to a fiscal cliff. Soon after, promises of the $50 billion Rural Health Transformation Program signaled an opportunity for financial relief.
While the outcome of these changes is still uncertain, revenue cycle leaders still face ongoing staffing challenges, causing many to look deeper into working with medical billing and coding companies. To realize the full potential of these relationships and the place they should play in your strategic planning, leadership should take time to understand the current landscape and their options in responding to challenges.
Overview of Rural Health Hospital Closures
Over the last ten years, more than one hundred rural hospitals have closed their doors [1]. Currently, approximately seven hundred additional facilities – representing one-third of the nation’s rural hospitals – report that they face imminent closure risk.
This erosion of services creates critical care deserts – even insured community members find themselves with nowhere local to receive treatment. A persistent trend involves labor and delivery. In the past five years, over one hundred rural hospitals have discontinued labor and delivery services [2]. Fewer than half of all rural hospitals now provide these essential services.
These hospitals face these issues largely because of declining reimbursement from health insurance plans, which fails to cover the cost of delivering care. Existing federal programs do not adequately address this financial instability, and some proposed adjustments could intensify the problem.
Responding to these challenges places increased burden on revenue cycle leaders to do more with less and consider working with medical billing and coding companies, maintaining revenue cycle health even as staffing challenges in revenue cycle persist.
Staffing Challenges for Rural Hospitals and Health Systems
Rural hospitals and health systems are dealing with a multifaceted staffing crisis that directly threatens their financial viability [3].
Providers are struggling to recruit and retain competent revenue cycle personnel in the midst of regular operational challenges. One hospital CEO described a catastrophic EHR transition that ballooned accounts receivable to 284 days, a situation exacerbated by a complete absence of local talent to help manage the fallout. Other leaders have highlighted the difficulty of finding staff with the specialized expertise required to navigate complex, high-dollar claims.
But the problem isn’t only recruitment. Retention is also a challenge. Decades of institutional knowledge are often lost when seasoned employees accept more lucrative, remote positions elsewhere, creating a revenue cycle brain drain.
These workforce shortages emerge from several interconnected areas. Rural locations inherently struggle to attract professional talent, with geographic isolation and fewer community resources acting as significant deterrents. Those who do join the team often confront extreme burnout from overwhelming workloads, accelerating turnover and further depleting the remaining staff. Beyond this, rural hospitals frequently cannot extend competitive salary packages, housing support, or educational opportunities that might incentivize a long-term commitment.
This chronic understaffing pushes many facilities toward the brink of closure, jeopardizing all community health services. To bridge gaps, administrators often resort to expensive temporary staffing agencies, a stopgap measure that only deepens their financial distress and creates an unsustainable cycle. A more viable solution is working with a medical billing company in USA that understands the challenges of the revenue cycle and can bring with them the added value of deep industry experience.
Responding to Rural Staffing Challenges
Confronting these staffing hurdles takes a strategic, multi-pronged approach that often includes forming a partnership with specialized medical billing and coding companies along with other strategic choices.
1. Get In Front of Concerns
Leadership must proactively manage potential community or board apprehension regarding outsourcing. One effective method involves conducting a limited pilot project with a vendor to quantitatively demonstrate value. An executive from Oklahoma showcased the expertise available through a partnership with a dedicated medical billing company in USA, which recovered $2.1 million in previously lost reimbursements – a result that convincingly alleviated all board concerns.
2. Keep Your Culture Flexible
Cultivating a people-first culture is vital for successful billing and medical coding outsourcing.
Both the hospital and the revenue cycle vendor must champion a culture of continuous development and growth. This philosophy helps internal teams view the change as a chance for advancement rather than a threat. As revenue cycle functions increasingly incorporate automation and artificial intelligence, upskilling personnel becomes imperative. For a rural health center seeking a proficient medical coding company in USA, selecting a partner that prioritizes its people translates directly to better performance and smoother collaboration.
3. Focus on Implementation
A seamless implementation forms the bedrock of a productive partnership with medical billing and coding companies. Make sure your team is ready for changes in their workflows, meetings with your vendor partner, and a focus on performance data.
Getting Started on Selecting an Outsourcing Partner
The uncertainty and new opportunities in rural healthcare mean that now is an excellent time to consider new partnerships in working with medical billing and coding companies.
3Gen Consulting specializes in helping healthcare providers navigate these exact challenges. From medical coding to denial management, our team ensures you stay compliant, maximize reimbursement, and adapt quickly to CMS rule changes. Let’s future-proof your rural health revenue cycle. Contact us today to discuss how we can help you respond to changes in rural health, strengthen your billing processes, and protect your bottom line.
References
[1] Center for Healthcare Quality and Payment Reform, “The Crisis in Rural Health Care,” 2025. Available: https://ruralhospitals.chqpr.org/.
[2] D. Muoio, “Rural hospitals’ labor and delivery closures increased in 2025,” Fierce Healthcare, 11 November 2025. Available: https://www.fiercehealthcare.com/providers/rural-hospitals-labor-and-delivery-closures-increased-2025.
[3] P. Murphy, “Empowering effective revenue cycles in rural health care,” National Rural Health Association, 11 January 2024. Available: https://www.ruralhealth.us/blogs/2024/01/empowering-effective-revenue-cycles-in-rural-health-care.
