January 14, 2016 Do Rural Residents Deserve Less Access Than Their Urban Counterparts? Health care is undergoing a major transformation as we move from a volume-based model of care to a value-based model. The Triple Aim focus of improved patient experience, population health, and reduced health care costs is appropriate. But not every hospital can get to the destination at the same pace or even in the same way. The challenge is greatest for small, rural providers.