Pa. House Republican Policy Committee Focuses on Challenges in Rural Health

January 22, 2026

Pennsylvania’s rural hospitals play a vital role in their communities, but they need support to ensure their long-term stability.

On Thursday, HAP and the hospital community testified during the House Republican Policy Committee focused on solutions to protect rural health. The hearing comes on the heels of a national report from Oliver Wyman released yesterday highlighting the ways care is at risk in Pennsylvania, especially in rural areas.

Here are three takeaways from the hearing:

1. The role of rural hospitals

Rural hospitals are the safety net for their communities. This role goes beyond the care provided and extends to the ways they propel their local economies.

But challenges stand in the way of their sustainability, including workforce shortages across specialties, transportation barriers, regulatory and operational hurdles, and compliance burdens.

“These may seem administrative in nature, but (for) a small hospital they have a ripple effect,” said Stephen Wolfe, president and CEO, Indiana Regional Medical Center.

Chronic underfunding for care is a core issue. Increasing Medicaid reimbursement, protecting the 340B program, streamlining licensing and credentialing process, addressing regulatory burdens, supporting EMS and IT infrastructure, and developing transportation solutions are just a few ways to support rural health care, Wolfe noted.

“What hospitals in Pa. are making versus other states in the country in terms of medical assistance/commercial (insurance) is really jaw-dropping,” Wolfe said, highlighting the Oliver Wyman report.

2. A focus on solutions

Pennsylvania’s hospitals are partnering with colleges and universities to grow the rural health care workforce, creating a pipeline that will train the next generation of rural caregivers. There is a need for clinicians of all types and at all levels of care, the panelists noted.

The hearing was held in Indiana County, where the Indiana University of Pennsylvania is in the process of developing a proposed college of osteopathic medicine to support the rural health care workforce.

Training providers in rural areas helps secure their employment locally after they finish their training, the panelists noted. Growing rural residency programs and developing other incentives to work in rural regions will strengthen this pipeline of future caregivers.

“These education practice partnerships ensure that students move efficiently from training to employment, strengthening local health systems and improving access to care,” said Lara Luetkehans, PhD, provost and vice president for academic affairs, Indiana University of Pennsylvania.

This work starts early, getting high school students engaged in health care careers.

3. Support for hospitals is crucial

Operating a hospital in Pennsylvania is more challenging than other states, with chronic underfunding, staffing shortages, and the highest per-resident cost of medical liability payouts in the nation.

Pennsylvania’s hospitals receive only 71 cents, on average, for each dollar they spend providing care to Medicaid enrollees. Recent changes at the federal level will reduce this to 64 cents on the dollar. Rural hospitals are at an elevated risk due to having a higher share of patients on Medicare and Medicaid.

“The status quo is unsustainable,” said Arielle Chortanoff, HAP’s vice president of state advocacy. “Hospital closures and service cuts are a statewide crisis that invites statewide solutions.”

The Oliver Wyman report and a fact sheet are available online. In addition, watch the hearing and see HAP’s prepared testimony.