Enhancing rural economic development: crafting a health care revolving loan fund

Community development efforts in economically depressed rural areas are often hampered by poor access to health care. One barrier to rural provider availability is the difficulty of obtaining capital for rural health care infrastructure development. Commercial lending institutions are limited in their ability to respond to these needs due to traditional lending criteria--creditworthiness, equity, experience, management ability, and profits or cash flow. This paper describes a rural health care revolving loan fund crafted to address these needs for capital while addressing the goal of improving health care access in rural Arkansas. The Arkansas Rural Health Revolving Loan Fund is a model for other states interested in two processes that work synergistically: (1) increasing access to capital to strengthen the rural primary health care infrastructure and (2) making health care more economically viable by integrating the fund's efforts with those of other community development initiatives.