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The PYA Center for Rural Health Advancement helps providers pursue data-driven and locally informed transformation to preserve access to high-quality essential services and to connect the community to the broader care continuum. We understand rural is not small urban; rural providers face unique challenges demanding customized solutions.


PYA brings decades of experience working with rural providers to build and maintain the four foundations of long-term sustainability:

  • Community Engagement – Understanding and prioritizing community needs, aligning with community organizations, building and maintaining trust with area residents, enhancing access to affordable primary care services, and maintaining strong governance and leadership teams. 
  • Clinical Excellence – Engaging in service line planning and execution, pursuing collaborative relationships and provider alignment, and securing an adequate workforce.   
  • Financial Stability – Gaining access to needed capital, optimizing revenue cycle operations, making purposeful IT investments, and positioning for value-based contracting.    
  • Regulatory Compliance – Understanding and implementing new regulatory requirements, ensuring IT security, and preparing for and responding to survey findings.   

Our Center Delivers Value to Rural Communities

  • We are a full-service consultancy. Our team members—including accountants, auditors, clinicians, valuation experts, lawyers, and strategists—examine challenges and devise solutions from all angles.
  • We are recognized thought leaders on rural health issues. Our experts regularly present on these issues at national conferences and state hospital association meetings. Thousands of rural providers have participated in PYA webinars and relied on PYA white papers and articles.
  • We are innovators and bridge-builders, having helped numerous health systems develop and implement creative rural health strategies. 
  • We want long-term relationships, not one-and-done projects. We earn trust by pricing our work fairly, considering our clients’ circumstances.
  • Like rural providers, PYA remains fiercely independent. We answer to our clients, not outside investors.
  • We adhere to the highest ethical standards of the American Institute of Certified Public Accountants.


Whatever challenges your organization faces — or opportunities you want to pursue — PYA will provide expertise and experience. We offer a broad perspective, with a deep-and-wide knowledge of rural health policy, payment, and regulations. The following summarizes our work with rural providers over the last two decades:  

1. Market Assessment

  • Compile in a usable format relevant data from multiple sources to understand the hospital’s current market position as compared to relevant benchmarks
    1. Demographics
    2. Regional provider inventory
    3. Hospital service line inventory and performance
    4. Hospital financial indicators
    5. Hospital quality indicators
  • Utilize assessment to identify immediate opportunities and to evaluate performance over time
  • Facilitate community health needs assessment

2. Revenue Cycle

  • Evaluate and develop detailed action plans to improve revenue cycle operations
    1. Front-end (financial counseling, patient access, upfront collections)
    2. Middle (charge capture, clinical documentation improvement, query process)
    3. Back-end (patient financial services, denials management, adjustments, and write-offs)
    4. Commercial payer contract compliance (actual payment vs. contract rates)
  • Assist with commercial contract negotiations
    1. Compilation of relevant market data
    2. Impact analysis
  • Maximize cost-based reimbursement
    1. Review and update chargemaster
    2. Review and correct inaccurate cost allocations
    3. Evaluate the process for filing interim cost reports based on significant events

3. Patient Care Revenue

Develop and support the implementation of work plans to:

  • Reduce hospital services outmigration
  • Increase swing bed utilization
  • Optimize service lines
  • Perform provider needs assessment and develop a recruitment plan
  • Improve local access to primary care
  • Expand telehealth and virtual services
  • Enhance 340B programs
  • Leverage outreach opportunities

4. New Payment Models

  • Identify and evaluate opportunities for participation
  • Develop sustainable infrastructure to manage patient populations
  • Identify and pursue partnerships across the continuum of care

5. Capital

  • Prioritize infrastructure needs
  • Identify and pursue new sources of capital
  • Develop and execute real estate strategy

6. Non-Patient Care Revenue

  • Evaluate current philanthropic resource development efforts to identify opportunities
  • Identify potential grant funding opportunities for specific initiatives
  • Manage grant reporting and compliance

7. Compliance

  • Provide regulatory updates and implementation work plans
  • Conduct mock surveys and develop and execute corrective action plans
  • Support 340B annual compliance
  • Assist with compliance program design, implementation, and ongoing support

8. Information Technology

  • Optimize IT investments
  • Mitigate cybersecurity risks
  • Assist with breach mitigation and response
  • Analyze critical systems and technology controls

9. Governance Processes

  • Evaluate and make recommendations regarding governing board structure, membership, operations, and oversight function
  • Provide timely and relevant board education
  • Facilitate board retreats and planning sessions

If you would like guidance with any matters related to rural health, one of the executives listed on this page would be happy to assist. You may email them through their contact links, or call (800) 270-9629.