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Advancing the Transition to a High Performance Rural Health System

Despite decades of policy efforts to stabilize rural health systems through a range of policies and funding programs, accelerating rural hospital closures combined with rapid changes in private and public payment strategies have created widespread concern that these solutions are inadequate for addressing current rural health challenges. This paper presents strategies and options that rural health providers may use in creating a pathway to a transformed, high performing rural health system, which are then categorized into four distinct approaches. We elaborate each approach, and discuss a related set of public policy implications that should be considered when following each strategy. We follow the discussion of policy implications with four demonstration ideas that reflect the essential elements of each strategic approach in achieving the aims of a high performing rural health system.

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RUPRI Center for Rural Health Policy Analysis
University of Iowa
College of Public Health
Department of Health Management and Policy
145 Riverside Drive, N200 – CPHB
Iowa City, IA 52242
Phone: (319) 384-3831
Fax: (319) 384-4371
Web site:

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