State health policy and rural hospitals

Many rural hospitals are experiencing difficulties. This article explores the views of various government and hospital officials on state health policy for rural hospitals. The authors discuss how these officials define the rural hospital issues and suggest appropriate state interventions to assure hospital viability and local access to care. The authors recommend that states, hospitals, and communities decide through a formal process what level of health and medical care should be available in rural areas, and states assist in low-cost ways those rural hospitals that are ready to change or that, with help, will be ready to make such operational changes as service reconfiguration, affiliations, and working agreements with other health care organizations to continue and improve local access to health care.