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Rural Health Reform Initiative

The Rural Health Reform Initiative (RHRI) was formed in 2009 by the Oregon Association of Hospitals and Health Systems to help answer the question: How can the state’s small and rural hospitals stay sustainable and meet the Triple Aim goals of better care, better health and lower cost while maintaining the highest levels of quality care?

Rural hospitals often have more obstacles to overcome than their urban counterparts. These include lower patient volumes, a lack of a balanced source of payer types, limited workforce, distant locations, unique community characteristic, and constrained resources. This generates insufficient revenue to pay for operating expenses, a lack of providers to meet the needs of the community, among other issues. Despite the tremendous challenges that these hospitals face, Oregon’s small and rural hospitals have been leaders in financial and delivery system transformation, so that they can continue to meet the diverse and ever-changing needs of their communities.

The goals of RHRI include: 

  • Health care coverage and access to high quality services for all residents of Oregon;
  • Delivery system reforms that reward quality and greater value for dollars spent on medical care;
  • Predictable and sustainable revenue streams;
  • An adequate supply of health care professionals;
  • A common-sense approach to regulating health care providers that ensures accountability but allows for flexibility to support a transforming health care system; and
  • The continued operational and financial viability of rural hospitals during and after the public health emergency.