Needs Analysis for Change

Student Name

Capella University

NHS FPX 6008

Professor Name

Submission Date

NHS FPX 6008 Assessment 2 aims to provide insight into what leadership should do about inequities associated with financing and funding for rural and other underserved communities. This process will support the identification of actionable strategies (e.g., policy changes, increase in workforce, telehealth, and local healthcare worker training) that improve the health outcomes for those populations. Ultimately, the intention is to find solutions that will provide improved access and quality of care as well as sustainability of healthcare services for Intermountain Health’s service areas.

Economic Issue Impact and Rationale

Rural populations are facing barriers in obtaining quality healthcare, many of which result from the manner in which the United States finances its healthcare. The funding challenges facing Intermountain Health and other providers are due, in large part, to an insufficient supply of funding for chronic care facilities. These facilities have closed their doors or reduced staffing, thereby causing patients who require care to travel longer distances to access those services. In turn, patients are having to wait longer to be seen (or seen by) a physician, are limited in access to preventive services and specialist physicians, and are waiting longer than ever to be seen in an emergency room.

The demand for care, at times, has caused distress among healthcare workers (particularly among emergency nurses) because they do not have adequate resources to provide the care that they would like. My interest in this issue comes from the interplay of policy, finance, and outcome, and my professional interest in equity, advocacy, and responsible management of scarce resources. I have worked in quality assurance and clinical training with an understanding of reimbursement models and how thin healthcare margins have directly impacted both the healthcare system and patient confidence in the system, as supported by studies and evidence.

Socioeconomic and Diversity Disparities

Inequities in the population that have enrolled with Medicaid are experienced at a much higher level in rural regions and disadvantaged areas than in other regions due, in part, to variations in the level of available Medicaid funding to support rural and disadvantaged areas as opposed to other areas. Additionally, there is a higher likelihood that hospitals and/or providers will close (which ultimately leads to higher rates of death or hospitalization) in areas that have a higher percentage of patients who are identified as belonging to a minority population than in areas where there are fewer patients who belong to a minority population.

Ultimately, the relative harm (e.g., hospital closures and/or lost capacity), in comparison to non-minority Medicaid patients, sustained by patients with a Medicaid insurance plan will be greater than that experienced by Medicaid patients generally (Hoffman et al., 2025). Based on the data as of June 30, 2024, there are approximately 7,501 Health Professional Shortage Areas (HPSA) in the United States that serve a total of approximately 75 million, or approximately 75 per cent of the entire population of the United States (Health Resources and Services Administration, 2024). In addition, approximately 66.5 per cent of the rural population in the United States lives within an HPSA (Health Resources and Services Administration, 2024).

Gap analysis, like that in the Intermountain Health Region, can therefore also include physical gaps (actual gaps between physical assisting locations). As per the example in the Intermountain Health Region, the low-margin sites and clinics are shortening their hours of business, which literally translates into gaps in services.

Evidence-Based Need for Change

Researchers have demonstrated that when rural hospitals close, there are adverse effects on access and outcomes. According to Hoffman et al. (2025), rural hospital closures are associated with an increase in inpatient deaths, an increase in emergency transportation times to hospitals, and a disproportionate rate of impact on Racial Minorities and Medicaid recipients. The conclusions show that keeping hospitals open within communities is not a simple logistical challenge, but rather a direct relationship between nursing and education, patient survival, and equity. Therefore, it is likely that increased staff numbers and investment in education for nurses in the rural areas will lead to a reduction in death and negative events rate and an increase in patient safety.

The payment policy is a source of rural facility fragility. According to an analysis of rural providers, the estimated losses in Medicaid funding involved rural hospitals that could lose significant portions of Medicaid funding and experience increased uncompensated care (National Rural Health Association, 2025). Such fiscal strains directly compel cuts in services and service shutdowns; that is, policy tools such as raises in Medicaid rates or special bridge funding become key components of a feasible implementation plan.

Telehealth has expanded access to care, reduced no-shows, and facilitated chronic-disease care within rural communities, enhancing patient experience and compliance (Haleem et al., 2021). Facility loss and damage were also compensated in part by provider-to-provider consultations and remote monitoring provided through telehealth, which also increased access to specialty care. It can be implemented by investing in broadband, training, and sustainable reimbursement to incorporate and not replace the local services with telehealth to alleviate travel burdens on low-income patients.

Predicted Outcomes and Growth Opportunities

Installing specific payment changes, adjustment of Medicaid rates, and temporary bridging funding will stabilize the finances of rural clinics and critical-access hospitals within the region of Intermountain Health. Permanent revenue ensures that the service-line reductions and closures are minimized and local primary, obstetric, and emergency capability is maintained. To payers and the system, avoiding closures would save the incurred emergency and inpatient escalations that come about as a result of late or disjointed care.

Enhancing nurse staffing, investing in BSN-prepared nurses, and increasing the capacity of the primary-care workforce will enhance clinical efficiency and safety and provide quantifiable returns on the economy. Telehealth scale-up is a complement to workforce investments that decreases overhead per visit, missed visits, and increases specialty access, saves patients time and lost wages, and enables clinics to serve a larger number of patients without corresponding facility growth, enhancing marginal revenue per clinician hour.

Collectively, these transformations create economic growth and resilience of the region. Local hospitals maintain jobs, ancillary firms, and a local tax base with multiplier effects of the local retail and services. In the case of Intermountain Health, the organization will have a more consistent margin, reduced uncompensated care, better payer negotiating position, and increased performance on value-based contracts, which will allow the organization to reinvest in prevention, workforce development, and community health programs to create a more financially sustainable platform.

Conclusion

The inequality in the financing of healthcare provision has weakened the rural and safety-net services, which have led to the closure of the clinics and hospitals and deterioration of access to healthcare by low-income, Medicaid, and minority populations. Unfair payment and low operating margins to warrant service cut-offs, understaffing, and the shutting down of staff are the most prominent loopholes. The reforms of payment, investment in the workforce, and telehealth replenish local capacity. This will save money, create equity, and restore resiliency of the communities.

Are you looking 3rd (next) assessment of NHS-6006? Visit: NHS FPX 6008 Assessment 4