Rural healthcare leaders lack planning capacity, funding required for capital projects: new research

Rural healthcare leaders are struggling to meet demand and lack planning capacity and funding required for capital projects, according to new research by Wold Architects & Engineers.

Rural healthcare systems across the U.S. recognize urgent unmet service needs in their communities, yet many are unable to launch new capital projects. The findings point to a widening gap between community demand and execution readiness, as financial pressure, staffing constraints, and planning complexity converge.

The research found:

• 72% of healthcare leaders say they are not well-equipped to plan, design, and construct capital improvement projects
• 53% report significant unmet demand for emergency or urgent care
• 55% cite a strong need for senior-focused services
• Only 18% have applied for funding through the $50 billion CMS Rural Health Transformation program
• 75% believe funding sources likely exist but that they have not yet identified
• 73% say coordinated, multi-party funding structures, including public-private partnerships and regional coalitions, are essential to securing capital

Financial pressure continues to shape decision-making. Nearly two-thirds of respondents report operating margins under strain. Additionally, more than half cite cost, planning complexity, and navigating funding as primary barriers to advancing infrastructure investments.