Case Study

Texas A&M and Eide Bailly: Improving Access to Healthcare in Rural Texas

September 19, 2025

Texas A&M Rural and Community Health Institute| College Station, TX

The Texas A&M Rural and Community Health Institute (RCHI) is a health extension center working to promote safe, effective healthcare practices in rural Texas. RCHI serves as a bridge for healthcare professionals and their organizations with academic centers, policymakers, and researchers to improve the quality and safety of patient care.

“We help facilities optimize service lines, identify opportunities for improved reimbursement, and get the most out of their contracts, so their doors can stay open,” said Melissa Lackey, Director of Rural Health Support at RCHI.

As the challenges facing rural hospitals across Texas intensified, it became clear that RCHI would need a partner with deep financial and operational expertise to help hospitals remain viable. That’s when they turned to Eide Bailly.

KEY RESULTS

Expanded financial support
Revenue cycle improvements
Increased reimbursement
Enhanced operational efficiency
Increased recognition across Texas
Successful contract negotiations

Healthcare

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The Problem

Rural healthcare facilities lack internal resources to produce certain programs and services.

Texas has faced a crisis in rural healthcare over the past decade. Twenty-one rural hospitals have closed, the highest number in any state, and many others have scaled back essential services like labor and delivery. The driving forces behind these closures include dwindling reimbursement rates, shrinking populations, rising operating costs, and increasing levels of uncompensated care.

For small, rural hospitals, even maintaining basic services can be financially unsustainable.

“These are small community or rural facilities that may find it difficult to produce certain programs and services on their own,” Lackey explained. “When a hospital closes, it doesn’t just impact patient care — it affects the whole community’s economy, access, and well-being.”

To help address these challenges, RCHI launched the Center for Optimizing Rural Health in 2018 through a grant from HRSA, engaging a cohort of rural hospitals nationwide to focus on financial and operational improvement activities. At the core of their strategy was a long-term partnership with Eide Bailly. Since the very beginning, Eide Bailly has played a critical role in supporting financial and operational improvement projects across rural Texas. The success of this project, which ended in 2023, set the foundation for a similar program exclusively focused on rural Texas hospitals and clinics. Funded through the state legislature, the Texas A&M Health Rural Engagement Program brings together a variety of colleges and resources across the Texas A&M Health Science Center. Once again, RCHI looked to Eide Bailly as a key partner to provide valuable financial consulting and resources to the hospitals and clinics they were serving.

The Solution

A collaborative approach identifies opportunities for improvement and establishes tailored assistance plans for each facility.

RCHI works closely with each hospital to assess their specific challenges and opportunities, with financial issues typically at the top of the list. Once needs are identified, Eide Bailly is brought in for discovery calls and planning to create customized technical assistance plans for each facility.

Services provided by Eide Bailly range from conducting revenue cycle assessments, chargemaster reviews, and denial analysis reviews to providing educational webinars and individual consulting with hospitals.

“Eide Bailly has been instrumental in helping us move those projects forward,” Lackey explained. “If it’s related to finance or operations, Eide Bailly has the expertise to address it.”

"Eide Bailly has been instrumental in helping us move those projects forward,” Lackey explained. “If it’s related to finance or operations, Eide Bailly seems to have the expertise to address it."

-Melissa Lackey, Director of Technical Assistance | ARCHI

The Results

With financial and operational expertise from Eide Bailly, RCHI is expanding services and support to facilities across rural Texas.

Starting with the Center for Optimizing Rural Health, and most recently through the work of the Rural Engagement Program, RCHI has significantly expanded the scope and depth of their support services to include payer contract analysis and negotiation, as well as strategic planning and regulatory compliance support.

“Rural hospitals fill a critical need in our communities, but they are usually working on a shoestring budget. I think we’ve been extremely beneficial in helping hospitals identify opportunities for reimbursement and mechanisms to support financial viability” Lackey said.

One of the most impactful efforts has been Eide Bailly’s support with chargemaster reviews, identifying outdated pricing structures that left hospitals underpaid for essential services, and more recently in payer contract negotiations. Many hospitals hadn’t renegotiated contracts in years and weren’t aware of the reimbursement terms — or even if they were being paid fairly.

“I can say with confidence that every project we have completed with Eide Bailly renders recommendations and concrete actions for improvement,” says Lackey. “We’re lucky to be able to partner with them to implement those recommendations and continue offering ongoing support.”

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