5 Innovations Strengthening the Rural Health Care Workforce

Rural health care has never had the luxury of waiting for perfect conditions. With smaller teams, tighter margins and vast service areas, rural hospitals have long been forced to innovate out of necessity — testing new workforce models, building unconventional pipelines and redesigning care with fewer resources and higher stakes. As workforce shortages deepen nationwide, many of the most practical, scalable solutions are emerging not from large urban systems, but from rural communities willing to rethink how talent is developed, supported and retained.

That spirit of ingenuity was on display during “7 Minutes to Innovation: Strengthening the Rural Health Care Workforce,” a fast-paced session at the AHA Rural Health Care Leadership Conference last week, where leaders from across the country shared real-world workforce strategies already delivering results. In seven-minute segments, presenters spotlighted approaches that move beyond recruitment incentives to address the full workforce lifecycle — from early exposure and training redesign to culture-building and leadership development.

5 Rural Workforce Development Strategies

1 | Starting Early: Building the Pipeline at Its Roots

One of the clearest themes of the session was the importance of reaching future health care workers long before traditional recruitment begins. At York General in York, Nebraska, leaders partnered with York Public Schools to give high school students hands-on exposure to health care careers. Since the collaboration launched in 2016, more than 150 students have participated, logging more than 10,000 hours in hospital and clinic settings.

The program gives students opportunities to observe daily clinical routines, participate in classroom and hands-on learning experiences and explore a range of health care careers through job shadowing and internships. The results are tangible: Multiple participants have gone on to receive full-tuition scholarships or enter medical and clinical training programs, and several have returned to York General as employees. For a rural community of just over 8,000 residents, the approach demonstrates how local partnerships can create a homegrown workforce pipeline aligned to community needs.

2 | Culture as a Workforce Strategy

At FirstHealth of the Carolinas in Pinehurst, North Carolina, workforce innovation begins with culture. Following the pandemic, leaders recognized a decline in employee engagement and a weakening pipeline from local community colleges. In response, the organization doubled down on initiatives designed to rebuild trust, connection and opportunity.

Leadership-led engagement strategies such as “Walk in My Shoes,” CEO listening sessions, employee recognition videos and expanded well-being supports helped restore engagement to the 82nd percentile nationally. At the same time, FirstHealth launched a $20 million capital campaign to fund student sponsorships, apprenticeships and faculty stipends while creating internal academies for EMTs, medical assistants and other key roles. The combined focus on culture and career pathways illustrates how workforce stability is closely tied to organizational values and long-term investment, not just compensation.

3 | Redesigning Training to Attract Rural Physicians

Sanford Health’s Bemidji, Minnesota, campus tackled a different but related challenge: how to attract physicians to rural practice when most training pathways remain urban-centric. Rather than relying solely on rural-origin pipelines or long-term rural training tracks, Sanford embedded short, high-value rural rotations within predominantly urban residency programs.

Launched in 2024, the model brings residents from Hennepin Healthcare in Minneapolis to Bemidji for one-month rotations in specialties such as emergency medicine and psychiatry, with expansions underway across additional disciplines. Early results suggest that even brief rural exposure can shift perceptions and career intentions. After years with no emergency medicine residents expressing interest in Bemidji, four did so in 2025 alone, and one ultimately chose rural practice. The approach offers a lower-cost, more scalable option for rural communities seeking to influence workforce decisions earlier in clinicians’ careers.

4 | Expanding the Workforce through Care Model Redesign

Innovation also extended beyond traditional clinical roles. At the Burlington-based University of Vermont Health Network, leaders reimagined utilization management and physician advisor programs to better support rural sites across multiple states. By standardizing processes, transitioning much of the workforce to remote roles, and centralizing non-clinical functions, the system achieved systemwide coverage with minimal additional staffing.

The redesign reduced administrative burden on clinicians, improved access to specialty support in rural settings and created new career pathways that enhanced recruitment and retention. The model underscores how workforce solutions can emerge from operational redesign, not just new hiring strategies.

5 | Developing Rural Nursing Leaders

Essentia Health in Duluth, Minnesota, focused its innovation on nursing leadership development, challenging common myths about rural nursing practice. Through a structured leadership bootcamp, data-driven decision-making and community engagement, Essentia empowered nurses to lead change locally while strengthening recruitment and retention. Leaders emphasized that rural nursing offers unique opportunities for skill development, autonomy and community connection, attributes that can be leveraged when supported by intentional leadership development.

A Blueprint for Action

Taken together, the session reinforced a central message of the Rural Summit: Rural workforce challenges are solvable when organizations are willing to innovate across the full continuum — from early exposure and training to culture, care models and leadership. While no single strategy fits every community, these examples offer adaptable frameworks that rural leaders can tailor to their own workforce realities.