HJAR Jul/Aug 2026

HEALTHCARE JOURNAL OF ARKANSAS I  JUL / AUG 2026 51 When you first stepped into the rural health transformation role, what did you feel was most important for you to understand about rural Arkansas be- fore making decisions? When people talk about “rural” Arkansas, there can be a misconception that all rural ar- eas are alike, and this presents a real danger of falling into a “one-size-fits-all approach” to finding real solutions to address Arkansas’s healthcare challenges. While the issues faced around the state are similar, the approach to addressing those challenges is going to be as varied as our state’s beautiful geography — whether it’s the Delta, the Ozarks, or the south- west region of the state. Early in my role, Governor Sanders’ adminis- tration asked me to get out of Little Rock and to begin meeting people where they live and work. We held 10 listening sessions across the state to present Arkansas’s rural health transfor- mation plan and hear from stakeholders — and continue to hold such meetings daily. Recog- nizing that workable healthcare solutions need to be tailored to the community, Arkansas has taken a unique approach to transformation na- tionally, focusing on grassroots solutions rather than the “one size fits all” top-down model, which I fear would be less impactful. The conversations with rural stakeholders — healthcare professionals and community lead- ers doing the hard work every day — taught me that the ideas to best address Arkansas’s rural healthcare challenges regionally are already out there — those ideas just needed to be heard and supported. Rural health transformation is a major opportunity, but also a major respon- sibility. How have you approached balancing urgency with thoughtful- ness? Rural health transformation is a major op- portunity. We anticipate Arkansas will receive just over $1 billion over the five years of the program. Rural health transformation has the potential to bring generational change to Ar- kansas healthcare, but only if we deploy those dollars carefully and strategically. However, by the nature of the program’s enabling legisla- tion, there is an inherent sense of urgency: States awarded funds under the Rural Health Transformation Program are competing with one another. At the end of each federal fiscal year, CMS, our federal partner in the program, will review how quickly we disbursed funds to our subrecipients and whether those funds were spent. If another state is more successful than Arkansas, we risk losing some of our fund- ing to a sister state. The converse is also true: If we are successful, we could see our award amount raised in subsequent years. The balance between urgency and thought- fulness is struck by relying on Arkansas’s ex- isting network of folks passionate about rural healthcare. While the rural healthcare transfor- mation program may be new, the work being done in Arkansas is not. My conversations with stakeholders — including hospitals, clinics, other providers, and existing partnerships — have revealed that good ideas for transform- ing rural healthcare already exist and that the Rural Health Transformation Program pro- vides the seed capital to put them into action. Many rural communities have seen programs come and go. What do you think about building trust with rural providers and communities during this process? President Ronald Reagan is credited with say- ing, “The nine most terrifying words in the Eng- lish language are: ‘I’m from the government, and I’m here to help.’” Programs designed to help rural communities are often designed by well-meaning individuals with no real connec- tion to the communities they aim to assist. The programs seek to address the perceived needs of the community without real input from the community. Programs designed this way are viewed with distrust and see little real buy-in at the local level. Community buy-in, trust, and support come from active community participation, excite- ment, and having local advocates for a pro- gram. Those things flow naturally from a pro- gram design process that clearly shows that people are being heard. For the Rural Health Transformation Program, we started the pro- cess early on. In October of last year, Governor Sanders established an online portal for shar- ing ideas on rural healthcare transformation. Nearly 300 ideas were received and considered and are reflected in the plan that Arkansas ul- timately submitted to CMS for approval. Next, we visited 10 locations across the state to lis- ten to community members about their needs and challenges related to rural healthcare. I continue to meet with individuals daily to get additional feedback. We have consistently said that the success of this program is dependent on receiving good ideas from the community. Those good ideas brought to us at the grass- roots level, that we hope to fund with transfor- mation dollars, ensure trust, buy-in, and strong advocacy at the local level. As someone who has spent more than two decades working alongside rural healthcare organizations across Arkansas, I appreci- ate Brad’s leadership and his encourage- ment of collaboration. The challenges facing rural healthcare are too complex for any one organization to solve alone. Hospitals, clinics, EMS providers, educational institu- tions, community organizations, and state leaders must work together to create lasting change. Throughout this process, Brad has consistently reinforced that the best solu- tions come from communities themselves and that transformation will be strongest when organizations work together rather than apart. That spirit of collaboration may ultimately become one of the most impor- tant legacies of Arkansas’s Rural Health Transformation effort. n Mellie Boagni President, CEO, and Founder Arkansas Rural Health Partnership