Community Health & Wellness

The logo for National Rural Health Day on Nov. 19, 2020

In Pennsylvania, half of the state’s 67 rural hospitals are operating at a loss, and many of those have been doing so for a number of years. Two thirds of those hospitals are operating with a margin of three percent or less, according to Dr. Lauren Hughes, deputy secretary of the PA Department of Health.


The reasons are clear: Their patients are older and have more chronic diseases, a larger percentage of them are uninsured and they often travel to urban areas for treatment. The Hospitals have a significant shortage of physicians both specialists and primary care doctors, the equipment they need is expensive and operating costs continue to increase.

The current fee-for-service model depends on volume, which results in erratic levels of funding from month-to-month. Whereas the new PA Rural Health Model provides the hospital with a predictable amount of funding. It’s called a global budget, and it’s much like a salary. With it, Wayne Memorial Hospital will need to plan, manage, save and invest the funding as they see fit to keep their population healthy.

The hospital is required to work with different groups to address community needs that impact health but are larger than the hospital. 


Wayne Memorial serves as lead on this project, with Wayne Tomorrow! and its task force offering collaboration and support. CEO Dave Hoff said the Rural Health Model Steering Committee has recommended an implementation strategy, which the Board of Trustees will be reviewing and approving shortly. 

A heading for the Rural Health Model Initiative explanation.

The PA Department of Health is working with a handful of hospitals to create new visions of health and specific initiatives for implementation. Each of them have shown a clear interest in participating in the six-year pilot program. In the first year, five hospitals have been chosen to begin the transformation, with an additional 12 in year two and another 12 in year three.

If the state reaches its goal, nearly half of the rural hospitals in the Commonwealth would be part of the pilot. In the fourth year,  the Department of Health will evaluate the program across the initiative and among the individual participating hospitals and decide whether or not to continue.

Pennsylvania is the first state to pursue this type of model, and therefore has been able to attract many partners and consultants to assist. The goals are financial stability and the transformation of health care.

Learn more.