Plans to Keep Mississippi Hospitals from Closing

Like many states in the nation, Mississippi is under a hospital crisis.  The reasons for the crisis are many, but the single greatest reason is that we are a state with few funds and many unhealthy citizens.  Combining this with low profit margins and increasing cost burdens for operations, it is no wonder why most Mississippi hospitals are designated as “at risk” for financial constraints or closures.

Mississippi has already lost six hospitals for full closure and six to bankruptcies.  Closures include Newton, Kilmichael, Belzoni, Natchez, Marks, and Senatobia.  Bankruptsies include Batesville (twice), Natchez, Clarksdale, Amory and Magee.

But, there are solutions that will help our facilities.  Most of these solutions were found through efforts of the Governor’s Rural Health Task Force, which convened in 2019 and produced a report with policy and legislative recommendations to assist all rural entities, including hospitals.  The recommendations were numerous, which well reflects the numerous issues that our facilities face.  These solutions primarily help with funding formulas, new funding pools for infrastructure, and increased access and efficiency.

Another positive solution comes from the Mississippi Hospital Association in the form of the Mississippi Cares plan.  This plan would utilize Medicaid funding and create a new provider-based insurance plan for low income citizens.  This would help to reduce uncompensated care and increase the insured rate of Mississippians.

Together, these solutions will help to solve our rural health crisis and help to support our rural hospitals.  Mississippi faces the same issues as other states, but being a poor state with low profit margins, we can’t afford to be wrong about the future of our healthcare.

RHCs to Receive Reimbursement Increase

The Mississippi Division of Medicaid recently announced that rural health clinics in Mississippi will receive a 1.9% increase in reimbursement for Medicaid encounters.  This rate increase will go into effect beginning January 1, 2020 for all RHCs in the state.  This reimbursement was initially passed by Congress and was funneled down through the Mississippi Division of Medicaid accordingly.

All clinics should have received a notice from the Division stating the increased rate and their new AIR including the 1.9% increase.

Click here to learn more.

For questions, contact Joe Jackson with the Division of Medicaid at 601.359.4040.

MRHA Partner Releases Book Focused on Hospital Survival

“Rural Hospital Renaissance” Gives Nation’s Struggling Rural
Hospitals Pathway to Growth and Revival”

New book and survival assessment tool provide at-risk hospitals with
a blueprint for engaging leadership, staff and patients to reverse the 
epidemic of closures and start growing.

A fifth of the nation’s rural hospitals are nearing collapse, according to North Carolina’s Sheps Center for Health Services Research, and 2019 is on pace to record the highest number of closings ever. With rural hospital closures at a crisis point, finding the pathway back to growth has never been more urgent.

“Rural Hospital Renaissance,” the new book by Brian Lee, one of North America’s leading experts in the field of Five Star patient experience, offers rural hospitals a proven formula for achieving a breakthrough in the patient experience to transform their future prospects from decline and survival to growth and revival.

“A cultural renaissance is needed in healthcare today,” says Lee, of the industry’s renewed focus on improving the patient experience. “The magic takes place when leaders truly engage the frontline with a ‘License to Please’ bundle of empowerment skills that transform their task-driven efforts to mindful presence and kindness. This book provides a step-by-step blueprint for transforming hospital culture and engaging caregivers to create a healing experience that patients will enthusiastically recommend.”

Lee says the patient experience is critical for rural hospitals, where patient volumes are declining due to the “drive-by factor” as tens of millions of dollars are lost to competing nearby urban tertiary hospitals. Because patients in these communities often rely on recommendations from their neighbors, friends and family when selecting a healthcare provider, “advertising will not bring back patients who don’t like you,” Lee emphasizes. “Word of mouth, will.”

“Rural Hospital Renaissance” explores evidence-based best practices that rural hospitals should take to engage patients and create a positive experience of healing kindness, including the four must-haves to become the hospital patients recommend: a culture of caring, frontline engagement, leadership and patient engagement.

“The patient experiences empathy and compassion through the actions of empowered frontline caregivers who become ‘patient relationship experts,’” Lee explains. “That’s why moving from decline and survival to growth and revival takes a strong commitment and some simple but profound changes in leadership and frontline behaviors. By following the practical, easy-to-do best practices outlined in this book, a renaissance is possible for every rural hospital. These are mostly simple things that leaders and caregivers can do while they’re doing what they already do, and they don’t cost a cent.”

Included in the book, Lee and his company Custom Learning Systems (CLS) introduced the Rural Hospital Renaissance “Survival Index” tool to help hospitals gauge their risk. While conventional research focuses on lagging indicators such as financial and volume factors tied to revenue, the Survival Index takes a proactive, comprehensive view by examining all the leading quality indicators that ultimately impact a hospital’s ability to survive in today’s economy.

Also launching as part of this effort is “,” and Facebook page “Saving Rural Hospitals” dedicated to addressing the epidemic of rural hospital closings. offers insights and resources, including the Survival Index Tool, for healthcare leaders and anyone who has an interest in being part of this movement.

Lee formally released “Rural Hospital Renaissance” in his keynote address to the Indiana Rural Health Association on National Rural Health Day, November 21, 2019.

About Brian Lee

Learn more about Lee here.

About Custom Learning Systems Ltd. (CLS)

Learn more.

Contact Bruce Lee at or by phone at 1-800-667-7325 ext. 213

Message from Charles James Regarding RHC Modernization Act Analysis

Below is a message from Charles James, president and CEO of the North American Healthcare Management Services, regarding the need for clinics to modernize and the need for the RHC Modernization Act.  We thought this was good to share!

Dear all –

I had a chat with John Gale after a recent exchange on the NRHA Grassroots listserve.  I had also recently heard John on an a radio Rural Hospital Closure Interview with a Kaiser Health News reporter, on which John did a great job framing our crisis.  (I had been meaning to call him!)

The listserve exchange demonstrated the persistent friction and misunderstanding b/w RHCs and FQHCs.  For me – all conversations lead to the the RHC Modernization Act. (Right – Bill 😉) John brought up the topic of the also persistent need for RHC data.  His team, Maine Rural Health Research Center/University of Southern Maine, recently released an analysis which demonstrates what many of us know and have discussed.  John and I also discussed RHCs lack of participation in Quality Payment Programs.  John was gracious enough to forward me their study, as well as recent presentations of his.  He also allowed me to share them.  I found them essential reading and thought you would too.

My own summary is that:

  1. Data supports our need to get in front of CMS on “RHC Modenization”, and the existential threat of of “site neutral payments” to PBRHCs.
  2. RHCs need to get IN on Quality.  Easy solutions exist:  PCMH = Advanced APM.  State Quality Program participation counts as well, in line with recent CMS-QPP guidance.  (eg MO has a fantastic PCMH program)
  3. RHCs could participate in Quality Payment Programs via HCPCS Code reported on their UB04 for various quality measures and UDS reporting.
  4. We must continue and strengthen our conversation with our FQHC cousins on how to collaborate, how we fit with one another, and how we differ.

That is likely more than $.50, but there it is.  I look forward to speaking with you all –

Best Regards –

Charles A. James, Jr.

President and CEO

North American Healthcare Management Services

9245 Watson Industrial Park • St. Louis, Missouri 63126

888.968.0076 Office

314.560.0098 Cell


Mississippi Governor’s Rural Health Task Force Report Released

It is my pleasure to report to you that the Mississippi Governor’s Rural Health Task Force report was delivered to Gov. Phil Bryant on Monday of this week.  This report is the culmination of multiple meetings across four months with a hand-picked committee of fifteen professionals, many of which are active MRHA members.  I had the pleasure of serving as the chair of this task force, representing and considering each of you as we had discussions and considerations of how to improve our state’s rural health system.

The task force focused on three key areas: sustaining and evaluating the current healthcare infrastructure, growing access, and transforming current healthcare practices into those of the future. These areas were intended to determine the root causes of Mississippi’s rural health issues and provide solutions specific to addressing those solutions.

The solutions in this report are those that the task force felt would best help to solve Mississippi’s rural health concerns.  The solutions include policy and legislative recommendations as well as opportunities for rural health strategy.

Now that the report is finished, the work can begin!  This report will serve as a roadmap for Mississippi for years to come, and we look forward to being a dedicated partner for substantial, system-wide improvements.

Download the Governor’s Rural Health Task Force report

Thank you for your continued membership, confidence and support.  We cannot do this without you!


Ryan Kelly
Executive Director
Mississippi Rural Health Association

NRHA Hosts Summer Leadership Symposium

Each year the National Rural Health Association hosts its summer leadership symposium.  This event brings together association leaders from across the country to learn from one another and share best practices on operating a rural health association and growing outreach and involvement in each respective state.  Ryan Kelly represented Mississippi at this meeting and was able to share many of the great updates from Mississippi.
“As the MRHA has grown in size and scope, the association has become a leader in the nation by helping other, smaller associations to learn how to develop membership and run events and programs.  And, in turn, we have learned a great deal from other associations,” responded Kelly.

To learn more about the National Rural Health Association and to join online, visit