By Roger Barnhart

One can not, not change – especially in business. And, though not always a popular perspective, healthcare is not only a business, it is big business. With many rural communities, the local healthcare system is the primary economic driver. It may sound harsh, but in business, it has been said that we are either growing, adjusting or dying.

As an avid fitness enthusiast, I can personally attest that I must either work to improve, or I will lose the progress I have made - requiring almost constant re-assessment and modifications to my programs. Especially as I age. What I was able to do 10, much less 20 or 30 years ago will no longer render the same results today. Very much like rural health.

by Roger Barnhart

The landscape within rural communities was very different in 1977 than it was 20 years later when Congress created the Critical Access Hospital (CAH) designation through the Balanced Budget Act of 1997. The intent was to reduce the financial vulnerability of rural hospitals and improve access to healthcare by keeping essential services in rural communities. In the 20+ years since, healthcare and the settings in which it is provided (and subsequent regulations) has continued to evolve.