A small, independent hospital in rural southeast Michigan has launched a national campaign to advocate
for rural hospitals and
against federal cuts to Medicaid and policy changes.
Hillsdale Hospital’s Rural Health Strong is a communications and advocacy campaign to promote the value of rural health and encourage the nation to take action toward preserving it.
The campaign is a response to Medicaid cuts introduced in the One Big Beautiful Bill Act, as well as other ongoing regulation changes and program cancellations that are already resulting in job cuts and the closures of rural hospitals.
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Hillsdale Hospital JJ Hodshire, Hillsdale Hospital president and CEO“We have to come together and lift our voices,” said Jeremiah J. Hodshire, president and chief executive officer of Hillsdale Hospital, located in Hillsdale, the county seat of Hillsdale County. “We’re financially viable right now, and to sustain that over time, we must be Rural Health Strong. Now is a critical time for us to support and advocate for all rural hospitals— our brothers and sisters around the country.”
The impact of the federal changes, according to various reports by healthcare organizations, will be particularly acute in rural areas.
The Medicaid cuts and other changes will result in significant coverage losses, reduced access to care, particularly for rural patients, and threaten the viability of rural hospitals and community health centers, according to the National Rural Health Association. State budgets, individual families and healthcare providers will sustain increased financial burdens, the organization said.
According to a report by the Pittsburgh-based Center for Healthcare Quality & Payment Reform, up to 13 rural hospitals in Michigan were already at risk of closing, including five at immediate risk, before the One Big Beautiful Bill Act was passed. The report did not name the hospitals.
“We seek to unite rural hospitals and equip communities to be advocates of rural health,” said Kyrsten Newlon, communications and donor development manager for Hillsdale Hospital. “This campaign will address the recent legislation that poses a serious threat to rural healthcare, and also provide education and regular updates on how cuts to Medicaid are impacting our industry and our communities.”
A report from the American Hospital Association says rural hospitals are already struggling. Nearly 50 percent of rural hospitals operated at a financial loss in 2023; 92 rural hospitals have closed their doors or been unable to continue providing inpatient services over the past 10 years; and rural hospitals lose money on several critical service lines, including behavioral health, pulmonology, obstetrics, and burns and wounds.
Last year Aspirus Ontonagon Hospital, the only full-service hospital in one of Michigan’s largest counties – Ontonagon County in the Upper Peninsula – closed, eliminating emergency services. The hospital reopened as a rural clinic, but residents must drive more than 45 miles to the nearest full-service emergency hospital.
The Rural Health Strong campaign is designed to promote rural health by growing awareness of the value that rural hospitals bring to their communities. Hospital leaders also hope the campaign will help tell the stories of those who will be most impacted by legislation that puts rural hospitals at a disadvantage.
The hospital identified several main areas of concern on the podcast,
Rural Health Today, and through other media channels.
“The work that (Jeremiah J. Hodshire) and his team at Hillsdale are doing in terms of advocacy is phenomenal, and we appreciate the increased awareness they are bringing to a variety of stakeholders through their Rural Health Strong campaign, and their Rural Health Today podcast,” said Crystal Barter, who is director of programs and services for the Michigan Center for Rural Health.
Steve Barnett, president and CEO of the McKenzie Health System in Sandusky, located in Michigan’s Thumb, welcomed the campaign, saying “any broadcast that highlights the value of rural health is useful.”
“Dripping a message is one technique that helps the public understand the issue,” he says.
The launch marks the first new campaign since the Hillsdale Strong. Hillsdale First. campaign, which the hospital initiated to encourage the community to choose local health services as their first option for care.
Among the main areas highlighted on the hospital’s podcast,
Rural Health Today, was the administrative burdens around work/community engagement requirements and the reductions to the provider tax, which allows many states to maintain their expansion programs (e.g. the Healthy Michigan Plan).
Another provision includes changes to Medicaid eligibility and more frequent redeterminations, which require every Medicaid recipient to re-enroll despite the lack of communication and resources around these events. Hillsdale Hospital and other rural healthcare providers have also expressed concern over reductions to the Federal Matching Assistant Percentage incentive, which helps support expansion states and boost hospital revenues where the Medicaid payer population is high, and a new cap in Medicaid State Directed Payment Programs.
“We became spokespersons against the legislation because of the devastation we knew it would have on the Medicaid population, which is a vital source of reimbursement for rural hospitals,” Hodshire said. “If carried out, this legislation will result in increased uncompensated care, lack of access for many patients, individuals losing coverage and ultimately, poor healthcare outcomes.”
Newlon says the response to the campaign so far has been enthusiastic from the community and the healthcare community.
“Our plan is to invite many rural hospitals and healthcare associations to participate in the campaign,” she says.
Hillsdale Hospital, located in a county of about 45,000 people on the Ohio-Indiana borders, serves a unique patient population. Its payer mix is about 75 percent Medicaid and Medicare, “meaning we have a disproportionate share of government payers,” Newlon says.
“Being in a rural area, we have a higher percentage of seniors in our community and we’re a lower-income county compared to the rest of the state. All this puts our patients in greater need of high-quality healthcare services that are locally owned and operated,” she says.
Hillsdale Hospital’s services include a state-of-the-art birthing center, general and specialized surgical services, primary care clinics, outpatient clinics for pain management, wound care and more. Without those offerings, local patients would have to drive 45 minutes to an hour and a half for those same services.
“However, many residents in our county don’t have the resources to travel for these services due to barriers like a lack of transportation, limited finances or insurance coverage, a shortage of child care, and other barriers," Newlon says.
The community, she points out, needs highly specialized care in its own neighborhood. When hospitals close their doors, the community impact is well known – the local economic wellbeing collapses, incoming industries struggle without care access, and growing families move away to find somewhere they can thrive.
“That’s why we’re launching this campaign — to reach our community, state and nation with the message of Rural Health Strong, encouraging every individual to take the time to learn and understand the value of rural health, then to help us protect it,” she says.
Hillsdale Hospital posted a video presenting the launch of the campaign to the public, and plans to publish multiple series of photos, videos, testimonials, analyses and more as a part of this campaign. They encourage the community and industry to follow along on their Facebook page (@HillsdaleHospital) and their website, hillsdalehospital.com.