This op-ed by Amanda Pears Kelly appeared on The Daily Yonder on June 30, 2026.
In southeastern Kentucky, where provider shortages, persistent poverty, and geographic isolation continue to shape daily life, one rural health center is quietly building a healthcare workforce from within its own community.
This month, Mountain Comprehensive Health Corporation (MCHC) will graduate another class of healthcare workers through its Reach, Achieve, Inspire, Support, Employ (RAISE) workforce development program — helping receptionists become nurses, medical assistants become nurse practitioners, and working adults earn degrees they once believed were financially out of reach, all while continuing to serve the communities they call home. To date, the RAISE program has upskilled nearly 200 employees, a powerful example of how community health centers (CHCs) can grow and retain a healthcare workforce from within the communities they serve.
At a moment when policymakers are debating how to stabilize rural healthcare systems amid sweeping Medicaid changes, programs like RAISE offer something increasingly rare in healthcare policy: a practical solution already working.
The program addresses one of rural healthcare’s most urgent challenges: workforce shortages. Instead of relying solely on outside recruitment, RAISE invests in people who already understand their communities and are committed to serving them.
“Life happens, and for one reason or another, people had to give up on their dreams,” said MCHC CEO Mike Caudill. “RAISE makes those dreams possible, affordable, and achievable again. We don’t have a shortage of dedicated people who want to serve their communities. We have a shortage of opportunity.”
RAISE is helping to change that.
National rural health workforce data consistently shows that providers who complete training in rural or underserved settings are significantly more likely to practice in those same communities long-term, yet rural regions continue to face limited access to those training environments.
Programs like RAISE demonstrate what becomes possible when those barriers are removed.
It also reflects the goals behind the new $50 billion Rural Health Transformation Program (RHTP), included in H.R.1, established to help rural providers navigate the largest restructuring of Medicaid in decades. Workforce development was identified as a key priority, and for good reason. Rural healthcare systems are under extraordinary strain.
CHCs are operating on increasingly narrow margins as workforce costs, inflation, technology investments, and uncompensated care continue to rise faster than reimbursement. Although Congress recently increased annual CHC funding from $4.3 billion to $4.6 billion, that extension only runs through the end of 2026, continuing a cycle of short-term funding uncertainty that makes long-term planning and innovation difficult.
At the same time,more than 200 rural hospitals have closed or partially closed since 2005, with 400 more at risk, and as coverage erodes, CHCs will be left to fill those care gaps, while absorbing the 5.6 million existing patients projected to lose their Medicaid coverage.
And yet, despite these pressures, CHCs consistently deliver measurable results.
For 60 years, CHCs have grown into a lifeline for 10 million rural Americans. They provide care in communities where provider shortages, transportation barriers, chronic disease, and economic hardship often intersect.
Importantly, they have also become laboratories for rural innovation.
CHCs meet patients where they are through mobile clinics, school-based care, telehealth expansion, integrated behavioral health services, transportation partnerships, and community health worker programs. They are developing workforce pipelines, modernizing care delivery, and coordinating social services in ways many traditional healthcare systems are only beginning to attempt.
Their work managing chronic disease generates a $13 return for every $1 invested in their operations and outperforms national benchmarks for diabetes, hypertension, and obesity that sit at the heart of the MAHA agenda. Unlike many healthcare systems, CHCs also operate under rigorous federal oversight and are governed by boards composed primarily of patients themselves, ensuring strong local accountability.
But innovation requires stability.
Rural transformation cannot succeed if the very providers driving that transformation are forced to operate in a constant state of financial uncertainty. Policymakers should view CHCs not as temporary stopgaps, but as permanent rural infrastructure worthy of sustained investment.
The communities most at risk already have proven systems in place. The question is whether policymakers will invest in strengthening and scaling them.
Because in many rural communities, preserving access to primary care is not simply about healthcare. It is about preserving the economic and social stability of the community itself. And increasingly, CHCs are the institutions holding that future together.
Amanda Pears Kelly is CEO of Advocates for Community Health.
This article first appeared on The Daily Yonder and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
