HJAR Jul/Aug 2025

HEALTHCARE JOURNAL OF ARKANSAS I  JUL / AUG 2025 69 Mellie Boagni CEO, President, and Founder Arkansas Rural Health Partnership where every party sees clear, tangible ben- efits. No one should feel like they’re being taken advantage of or that their unique identity or financial stability is being eroded. For a hospital-FQHC partnership to be truly successful and sustainable, we need to ensure: 1. Mutual respect for mission and expertise Rural hospitals and FQHCs both serve vital roles, often with overlapping patient populations but distinct operational mod- els and funding streams. Hospitals need to understand the FQHCs’ emphasis on com- prehensive primary care, prevention, and serving the underserved. FQHCs, in turn, can benefit from the acute care capabilities, specialized services, and potentially larger operational scale of a hospital. 2. Clearly defined roles and fair exchange What exactly is each partner bringing to the table, and what are they getting out of it? Is it shared revenue (where applicable and compliant), shared overhead, access to referrals, enhanced services, reduced emer- gency department utilization, or improved patient transitions? Be explicit. For hospi- tals, partnering with FQHCs can significantly reduce avoidable emergency department visits and inpatient readmissions, as FQHCs excel at managing chronic conditions and providing continuous, integrated primary care. For FQHCs, hospital partnerships can provide access to specialty care, diagnostic services, and potentially help with work- force recruitment. 3. Localized solutions, not one-size-fits-all Rural communities are diverse. A solu- tion that works in one farming community might not fit a mountain town. Partnerships should be flexible enough to adapt to local needs and respect community values. This means cocreating solutions, not just adopt- ing pre-packaged models. 4. Open and frequent communication This is key and should be the first prior- ity. Regular check-ins, shared data (where appropriate and secure, perhaps through integrated EHRs or robust referral tracking systems), and a willingness to troubleshoot problems together are critical. Misunder- standings thrive in silence. 5. Protecting local identity Both rural hospitals and FQHCs are of- ten pillars of their communities. Partner- ships should enhance — not diminish — local identity and connection. This might mean keeping local branding, ensuring commu- nity representation on advisory boards, or prioritizing local employment. When done right, these partnerships em- power us to do more with less, to provide a wider range of services closer to home, and to build a healthcare system that truly reflects the needs and strengths of our rural communities. It allows our dedicated hospi- tal staff to focus on acute care, knowing their patients have a robust primary care medical home; it helps FQHCs extend their reach and capacity; and, ultimately, it helps us keep our doors open and our communities healthy. So, let’s look around. If you’re a hospital, are you collaborating closely with your local FQHC? If you’re at an FQHC, how can you deepen those ties with the local hospital and ensure they thrive? The future of rural healthcare isn’t about isolated strength — it’s about connected resilience. Let’s build those connections, knowing that when we work together, we all get to thrive. n G. Allan Nichols, CEO of Mainline Health Systems Inc., graduated from the University of Arkansas at Monticello with a bachelor’s degree in science.Allan joined Mainline in September 2008. Before joining the Mainline team, he was the owner of a multiline insurance agency in Northwest Arkansas. Prior to owning his business, Allan worked in the marketing field,spending eight years as themarketing director for a large financial services corporation. a regional academic center for residency rotations. FQHCs, with their mission-driven focus, can be attractive training grounds for new providers — potentially inspiring new grads to stay. Even sharing administrative staff or IT support across a few small, independent clinics and the local FQHC can lighten the load and make rural practice more sustain- able. FQHCs also qualify for loan reimburse- ment programs like the National Health Ser- vice Corps. 3. Addressing social determinants of health (SDOH) In rural communities, health is often in- extricably linked to housing, transportation, food security, and local economic well-be- ing. We’re not just treating symptoms, we’re treating people in their environments. This is where FQHCs truly shine. Their core mis- sion is to serve the underserved, regard- less of ability to pay, and they are masters at providing “enabling services” like trans- portation, language interpretation, and so- cial work. Hospitals partnering with FQHCs can dramatically improve patient outcomes by connecting patients to these vital com- munity resources. Another key opportunity here will soon be making sure all patients complete the paperwork and requirements to maintain the appropriate healthcare in- surance or coverage. FQHCs have teams ready for this service. The “everyone eats” imperative: Making FQHC-hospital partnerships work for us The beauty of rural healthcare is its tight- knit nature. Relationships matter here. So, when we talk about partnerships, especial- ly between rural hospitals and FQHCs, it isn’t about a big-city hospital swooping in to “save” a struggling rural entity, nor is it about the FQHC simply being a feeder clinic. It’s about genuine, reciprocal relationships