By Mary C. Mayhew
This month, we celebrate National Rural Health Day, an annual occasion since 2011 to bring attention to and honor the work of rural healthcare providers, communities, organizations, and others dedicated to addressing the unique healthcare needs and challenges of rural communities.
Five rural hospitals closed in Florida over the last two decades, and three converted to providing emergency care only. Others cut services, such as labor and delivery and other specialty care.
When access to healthcare in rural communities is diminished, the ripple effects go well beyond medical care. Robust rural healthcare infrastructure is integral to a healthy rural economy and community life. When hospitals struggle or close entirely, jobs, tax revenue, and local spending are lost. Families move away, schools lose enrollment, churches lose parishioners, industries lose workers, and once thriving communities are diminished. Main Streets become ghost towns.
Florida’s lawmakers, both in Tallahassee and in Washington, D.C., are taking this challenge seriously, working on a bipartisan basis to support rural hospitals and, more importantly, support access to timely care close to home.
On the federal side, last year’s One Big Beautiful Bill Act, makes a once-in-a-generation investment in rural healthcare with the Rural Health Transformation Program. It appropriates $50 billion over five years to states to invest in rural healthcare innovation and transformation. Florida received $209 million for 2026, representing the single largest federal investment in rural health care in Florida. In August, Gov. Ron DeSantis announced nearly $188 million in round one awards to various institutions including clinics, hospitals, federally qualified health centers, educational organizations, and other healthcare providers in 31 rural counties to strengthen access to care. Projects include mobile health units, rural and satellite clinics, specialty telemedicine, and remote patient monitoring.
On the state side, in 2024, the Legislature made funding for the Rural Hospital Capital Improvement Program recurring, ensuring a reliable source of funds for rural hospitals to modernize and invest in the latest medical equipment, needed renovations, and new facilities to effectively meet the healthcare needs of their communities. Originally established in 1999, funding for the improvement program lapsed in 2008. In 2023, FHA urged the Legislature to revive it. The Legislature agreed and appropriated $10 million to the program and in 2024 made that investment recurring to support the ongoing modernization needs of rural hospitals.
For one rural hospital devastated by Hurricane Michael in 2018, the program provided essential funding to support it in rebuilding a new 50,000 square foot facility that re-opened in 2025, restoring access to essential emergency, inpatient, and outpatient services to its rural community. It used funds to add hospital-wide telemetry, new inpatient beds, and construction of a mobile MRI pad.
A second state investment in rural hospitals is the Health Care Innovation Loan Program. Although not exclusive to rural hospitals, the Health Care Innovation Loan Program – a result of 2024’s omnibus Live Healthy legislative package – provides low-interest loans to Florida’s rural hospitals to implement innovative healthcare solutions. Loans cover up to 80 percent of total project costs for rural applicants and carry a maximum 1 percent interest rate with 10-year repayment terms. One rural hospital used a loan to purchase a da Vinci 5 robotic system to be able to offer minimally invasive surgery to its patients, improving outcomes and reducing surgical complications and hospital length of stay. Another used it to add telehealth services, eliminating the distance and geography barrier to timely specialty care for many rural residents.
With meaningful federal and state support, rural hospitals and their partners are ensuring that rural Floridians have access to the full range of outpatient and inpatient healthcare services close to home when they need it and eliminating ZIP codes as an access-to-care determinant.
Looking ahead, when the Legislature reconvenes in November for committee work ahead of the session’s official start in March 2027, Florida’s hospitals will be supporting policies that build on the momentum of these previous state and federal investments. One key priority is to increase Medicaid reimbursement rates for rural and critical access hospitals to ensure payments meet their costs of providing care.
These investments in our rural hospitals and healthcare infrastructure are the seeds from which strong, healthy rural communities will grow and flourish for generations to come.
Mary Mayhew is President and CEO, Florida Hospital Association.
