Rural Hospitals
52
RHTP-eligible rural hospitals
Substantial Financial Risk
31
60% of eligible hospitals
HPSA-Designated Counties
52
of 67 total counties
Rural Population Served
2.1M
41% of Alabama residents
Alabama — Regional Health Overview
Northwest
Colbert, Franklin, Lauderdale, Lawrence, Marion, Winston
5 at financial risk
Appalachian
Cullman, DeKalb, Marshall, Jackson, Blount, Cherokee, Etowah
4 at financial risk
Metro Corridors
Jefferson, Madison, Mobile, Montgomery, Tuscaloosa
1 at financial risk
Black Belt
Wilcox, Perry, Hale, Dallas, Lowndes, Macon, Bullock, Greene, Sumter, Marengo
11 at financial risk
Central
Autauga, Chilton, Coosa, Elmore, Tallapoosa, Clay, Randolph
4 at financial risk
Wiregrass / Gulf
Coffee, Dale, Geneva, Houston, Pike, Henry, Covington, Escambia
6 at financial risk
Performance Objectives
58%
Living Healthier Lives
Well-controlled blood pressure among rural residents with high BP
Target: 10% relative improvement by FY 2030
15.2%
Quality Healthcare Delivered
30-day all-cause readmission rate among rural patients
Target: 10% relative reduction (national avg: 13.9%)
31%
Getting Care When Needed
Adults in rural areas reporting delayed care for non-cost reasons
Target: 10% relative reduction
52%
Durability of Care Options
Rural hospitals with operating margins sufficient for ongoing investment
Target: 75% by FY 2030
Operating Margin > 1%
27/52
52% of eligible hospitals
Target: 75% by FY 2030
Financial Plans Implemented
12/52
Year 1 progress
Target: 90% participation
MaineCare APM Adoption
49%
Medicaid reimbursement in APMs
Target: 60% by FY 2030
Regional Partnerships
8
New cross-organizational partnerships
Target: 100% increase over program
Rural Hospital Financial Health — Illustrative Sample
| Hospital | County | Region | Type | Operating Margin | Financial Plan | Risk Level |
|---|---|---|---|---|---|---|
| Wilcox County Medical Center | Wilcox | Black Belt | CAH | -2.1% | In Progress | Critical |
| Perry County Hospital | Perry | Black Belt | CAH | -0.8% | In Progress | Critical |
| Greene County Health System | Greene | Black Belt | CAH | -1.4% | Not Started | Critical |
| DeKalb Regional Medical Center | DeKalb | Appalachian | GACH | 0.4% | In Progress | At Risk |
| Marshall Medical Center North | Marshall | Appalachian | GACH | 0.7% | Enrolled | At Risk |
| Cullman Regional Medical Center | Cullman | Appalachian | GACH | 1.8% | Enrolled | Stable |
| Dale Medical Center | Dale | Wiregrass | CAH | 0.3% | In Progress | At Risk |
| Elmore Community Hospital | Elmore | Central | GACH | 2.4% | Complete | Stable |
| Covington County Hospital | Covington | Wiregrass | CAH | 1.1% | Enrolled | Stable |
| Dallas County Medical Center | Dallas | Black Belt | CAH | -0.5% | Not Started | Critical |
Operating Margin Trend — Illustrative Projection
% of Alabama rural hospitals with operating margin at or above 1%
Workforce Pipeline Metrics — Year 1 Illustrative Progress
Recruitment & Training
Clinicians committed to rural service
45 / 200
Career pathway programs launched
1 / 2
Students in health programs
190 / 500
New clinical preceptors
22 / 50
Workforce Gaps by Region
HPSA designations — primary care shortage areas by region
Access & Technology Adoption — Year 1 Illustrative Baseline
Technology Adoption
Adult telehealth utilization
12%
Youth tele-BH utilization
8%
Specialty telehealth access
15%
AI documentation adoption
6%
Target: 20% relative increase across all technology metrics by FY 2030. Specialty telehealth and AI documentation measured via practice surveys designed for Alabama deployment.
Healthcare Access
SUD treatment initiation (14 days)
39%
Breast cancer screening (50-74)
45%
Asthma medication ratio (≥0.50)
57%
Dark markers indicate national Medicaid median targets. Progressive improvement expected across Years 2-5 as investments in workforce, technology, and access take effect.
Transportation providers
12 vehicles
Target: +10 additional providers per year