Beyond Traditional Financing: A Strategic Approach to Funding Rural Hospitals and Community Health Facilities
Across the United States, conversations about rural hospitals frequently center on staffing challenges or service reductions. According to Katie Newman, there is also a less-discussed financial dimension that can influence whether care continues to be delivered locally. As founder and CEO of High Point, a healthcare-focused development and capital strategy firm that helps rural hospitals plan, finance, and deliver new medical facilities, Newman works with boards and leadership teams to explore funding structures that may initially appear difficult to pursue.
High Point operates at the intersection of real estate development and healthcare finance. In practical terms, the firm works alongside hospital executives from early concept planning through financing and construction strategy, helping define what should be built, how it should be funded, and how the project can remain financially viable long-term.
Rather than approaching projects through conventional debt and equity alone, Newman explains that her role is to assemble comprehensive capital stacks that may include grants, New Markets Tax Credits (NMTC), appropriations, and traditional lending.
“The greatest medical need growing in our country right now is tied to aging populations in rural communities,” Newman says. “At the same time, we are seeing behavioral health deserts, maternal care deserts, and communities where access to care can require an hour-long drive. If care is not accessible, it often goes unused.”
Recent national data underscores the strain on these systems. According to a report, 136 rural hospitals closed between 2010 and 2021, and financial vulnerability remains a persistent concern for many that remain open. While closures receive headlines, Newman suggests that the underlying issue frequently involves outdated infrastructure and limited access to affordable capital.
She notes that only a few hospitals nationwide carry a formal credit rating, a benchmark often required for favorable traditional financing. For many rural and smaller community hospitals, this limitation can narrow funding pathways. According to the reports, there are roughly 6,100 hospitals in the United States, with about 1,800 classified as rural community hospitals, highlighting the scale of facilities that may face unique capital challenges.
In response, High Point’s model centers on integration. Newman explains her work as bridging institutions that rarely engage directly, including community development entities seeking qualified projects, grantmakers requiring measurable impact, and lenders focused on debt service coverage.
Rather than asking hospitals to navigate each funding source independently, High Point coordinates these stakeholders into a single structured financing plan designed around the hospital’s operational realities. Each source has distinct criteria. “Every capital provider wants something different,” she explains. “Bridging the gap means creating mutual understanding and structuring a package that satisfies each mandate without compromising the hospital’s mission.”
She explains that one current project illustrates this approach. “In a Texas town of approximately 13,000 residents, a new rural health clinic is being structured to expand pediatric and behavioral health services,” she says. “By qualifying under rural health reimbursement frameworks, the facility is projected to improve annual revenue while broadening care offerings.” She emphasizes that the financial model is as important as the construction itself. From her perspective, improved reimbursement rates, diversified services, and right-sized debt can collectively strengthen a hospital’s balance sheet while keeping patients close to home.
“A similar philosophy guides a birthing center initiative in Washington State serving an Indigenous community located within a maternal care desert,” she notes. There, she explains that the distance to women’s health services can exceed 45 minutes. Newman frames the project as an example of how capital strategy and cultural context must align. “It is not just about building a facility,” she says. “It is about ensuring that the structure, the funding, and the services reflect the needs of the community.”
The infrastructure age adds another layer of complexity for many rural hospitals. Research indicates that U.S. healthcare facilities have deferred about 41% of their maintenance needs, resulting in an estimated $243 billion backlog of needed repairs and upgrades, a burden that disproportionately affects smaller and rural providers. From Newman’s perspective, modernized spaces and integrated services can improve operational performance and help support workforce stability in communities where recruiting and retaining clinicians is already a challenge.
Importantly, Newman frames the discussion not as a critique of traditional finance, but as a broader conversation about structure and alignment. She suggests that many boards assume large-scale projects require giving up ownership or taking on unsustainable debt, when alternative configurations may exist. In her view, the challenge is often one of awareness. “There is money available,” Newman says. “The key is structuring it correctly and bringing the right partners to the table.”
She positions herself as a strategist and developer, translating between healthcare administrators and complex capital sources. Through High Point, she works as a long-term partner to hospital leadership teams, helping them define the project scope, assemble layered financing, and guide the development process from feasibility through funding and project execution. Newman says, “The path forward is already there, it just needs to be structured.”
