HJAR Jul/Aug 2025

68 JUL / AUG 2025 I  HEALTHCARE JOURNAL OF ARKANSAS RURAL HEALTH COLUMN RURAL HEALTH IF you’re working in rural healthcare, you know it’s a different world. We’re often the backbone of our communities, providing care that goes far beyond the clinic walls. We also face unique challenges. Fromphysi- cian shortages and limited specialized ser- vices to broadband access issues and longer travel times for patients, the landscape can be quite challenging. Urban healthcare providers often strug- gle to find enough resources for all those in need, while rural providers struggle to find enough people to support the services that are needed. Sometimes, it can even feel like we’re out here on our own in rural areas, try- ing to keep a dozen plates spinning at once. But here’s the thing: We’re not alone. And the secret weapon for not just surviving, but thriving, in rural healthcare lies in some- thing we often already do intuitively but could do even better: partnership. And for rural hospitals and providers, a willing and capable partner could be your local federally qualified health centers (FQHCs). FQHCs are locally governed nonprofits focused on being high-quality providers that fill the voids in primary care. They are called Allan Nichols CEO Mainline Health Systems Inc. When the Arkansas Rural Health Partnership (ARHP) was first launched, our network was entirely made up of small, rural hospitals trying to survive in a system that wasn’t built for communities like ours. But everything began to shift when Mainline Health Systems, under the leadership of Allan Nichols, became the first federally qualified health center (FQHC) to join our all-hospital network. That moment wasn’t just symbolic — it was transformational. Allan brought not only the FQHC model to the table, but also a different lens through which to view the rural health crisis. His perspective challenged us to think differently — about collaboration, sustainability, and the way care is delivered across systems. And that perspective has made us stronger. Today, ARHP is not just a hospital network — it’s a collaborative community built on trust, shared mission, and the belief that when rural communities work together, we can create solutions that are both innovative and deeply local. As part of a new series for the Healthcare Journal of Arkansas, I set out to highlight some of the rural rockstars across our state — leaders who are quietly, yet powerfully, transforming the future of healthcare. Allan Nichols is one of those leaders. What Allan shares goes beyond commentary. It’s a call to action, rooted in lived experience and grounded in the realities of rural care. It’s real, it’s grounded, and it’s the kind of voice we need at the table. I’m proud to share his voice here — and even prouder to call him a partner in this work. Introducing Allan Nichols. –Mellie Boagni THE RURAL ADVANTAGE How Partnerships, Especially with FQHCs, Are the Lifeline for Healthcare in Our Communities by federal statute to be responsive to the needs of the communities they serve. They are also expected to collaborate and partner to best serve the patients and communities they serve. Why partnership isn’t just nice, it’s necessary in rural healthcare In urban centers, there’s often a built-in infrastructure and a larger pool of resources. Out here, we have to create our own. That’s where partnership becomes less of a luxury and more of a lifeline. Consider these common rural scenarios and how partnership can transform them: 1. The maternal health desert Every momdeserves access to high-qual- ity maternal care, but rural communities have seen maternal programs leave their towns for several reasons. The core issue that causes most maternal care programs to fail is call rotation. This is driven by the number of doctors, number of babies, and reimbursement rates. Doctors are people with families just like all of us, and they de- serve time with those families. To have an adequate call rotation, you need four doctors on weekend rotation. To generate cash flow for four doctors, you need approximately 200-225 babies per doctor. This means each community must deliver 800-900 babies per year. There are few rural communities that can do this alone. To reach more moms and cast a larger net, partnership with your local FQHCs can work. It has worked here in Southeast Arkansas. We have clinics across the area, and we now work with the local hospital to provide maternal care. The OB/GYNs and all clinical staff work for us. We refer moth- ers, not just from one community, but from the region. We now have a program that can come close to generating cashflow. 2. Staffing woes Recruiting and retaining healthcare pro- fessionals in rural areas is a constant uphill battle. It’s tough to compete with urban ame- nities and the sheer volume of colleagues. Partnerships can help here, too. Imagine a rural hospital partnering with an FQHC for shared resources or collaborating with