Planting the Seeds for Thriving Rural Health Care
2/1/2026
This article first appeared as a column in the February issue of South Florida Hospital News
By Mary Mayhew, FHA President and CEO
Rural hospitals and communities across Florida are getting much-needed support from the federal and state governments. From the federal Rural Health Transformation Fund to the state Capital Improvement Fund and Rural Renaissance legislation, Florida’s rural hospitals and communities are entering a new era of possibility.
Five rural hospitals closed in Florida over the last two decades, and three converted to providing emergency care only. And many others cut services, such as labor and delivery and other specialty care. Stemming this tide of closures and service line reductions requires sustained investment and policies that reflect rural communities’ unique challenges and demographics.
With meaningful federal and state support, rural hospitals and other healthcare providers can ensure that rural Floridians can access the full range of outpatient and inpatient services close to home when they need it. In addition, robust rural healthcare infrastructure is integral to a healthy rural economy. 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.
Federal and state policy developments are hoping to change that.
The federal One Big Beautiful Bill Act, enacted in July of last year, 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 this year, representing the single largest federal investment in rural health care in Florida.
Florida’s three primary focus areas for funding are improving access to care, strengthening the health care workforce, and advancing health care innovation. Among the state’s proposals are expanding clinical training and rural rotations; providing start-up funding for rural and satellite clinics; and investing in mobile health units, remote patient monitoring, behavioral health telehubs, and advanced telespecialty services.
On the state side, the Rural Hospital Capital Improvement Program provides ongoing infrastructure support for rural hospitals. Created in 1999, the Rural Hospital Capital Improvement program’s funding lapsed in 2008. In 2023, the FHA strongly advocated with the Legislature to revive this fund. The Legislature agreed and appropriated $10 million to the program and in 2024, made that investment recurring to support the ongoing needs of 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.
This year, the Legislature has the opportunity to build on that investment. In January, the Senate passed Sen. Corey Simon’s 2026 Rural Renaissance legislative package. The $145 million multi-sector package would improve roads, invest in schools, and expand healthcare resources. The healthcare provisions include increasing Medicaid reimbursement for critical access hospitals to align with costs and expanding the FRAME program to include emergency medicine physicians employed by rural hospitals. It would also create the Office of Rural Prosperity at the Department of Commerce to help local governments secure state and federal grants.
Investments in our rural hospitals are investments in a healthy Florida. Taken together, these various federal and state policies and funding vehicles reflect a renewed focus on our rural communities, infrastructure, and residents. They will support increased investment in the facilities, the people, the technology, and the partnerships that enable timely, accessible preventive, primary, and specialty care; advanced life-saving trauma care; chronic care management; behavioral health care; and post-hospitalization rehabilitation. They are the seeds from which healthy rural communities will grow and flourish.