In 2014, Harper County, Kan., found itself at an important crossroads.
Two hospitals – Harper Hospital in Harper and Anthony Medical Center in Anthony – stood just nine miles apart. Both had served their communities for decades. Both were sources of pride, jobs, and identity. Both were also struggling.
Each critical access hospital offered similar services: emergency care, inpatient beds, and rural health clinics. Together, they served a population of approximately 6,000 residents. But instead of strengthening the county’s healthcare system, the duplication strained it. The hospitals competed for physicians, nurses, patients, and funding. Both relied heavily on local tax dollars to stay afloat, and neither was financially secure.
At the same time, rural hospital closures were increasing across the country. By that point, more than 80 rural hospitals had already closed, and that number has increased to 107 today. For Harper County residents, the implications were relatively clear: one or both could close, eliminating local healthcare access altogether, with the closest assistance 30 miles away.
Both hospitals had deep roots in their communities. Built in the 1960s, they were more than healthcare providers; they were economic drivers and important symbols of local identity. Residents supported them not only as patients but also as taxpayers.
Yet the financial reality was growing more difficult to ignore.
The hospitals were built to support the needs of a county with 9,500 people. By the 2010 U.S. Census, the county population had fallen to 6,000 – a decline of more than 35%.
Operating costs were rising. Staffing was increasingly difficult, particularly in these rural communities. According to analysis from Leavitt Partners, patient volumes fluctuated, and both hospitals experienced low utilization rates (30-35%) compared with state and urban Wichita averages (39% and 60%, respectively). Federal reimbursement pressures and the lack of Medicaid expansion in Kansas added further strain.
Behind the scenes, both facilities were slowly losing ground.
What made the situation especially challenging was the competitive dynamic. Rather than collaborating, the two hospitals were often locked in a struggle for limited resources. Despite genuine compassion and a desire to care for each town’s residents, this competition weakened both organizations and made long-term sustainability unlikely.
Despite best intentions, patients and their families did feel the effects. In 2012, county residents in the county’s first federally mandated Community Health Needs Assessment identified “service/referral integration between Harper Hospital and Anthony Medical Center” as their top priority.
There was no turning away from it; the assessment formalized what everyone had been feeling. Although change was overdue, the prospect of change was also frightening. Across the rural United States, competitive dynamics in healthcare often play out as competitors weaken themselves while waiting for the other to fail first.
A reasonable question was whether there was a less damaging way to resolve this competitive standoff than a race to the bottom.
One person asking this exact question was the Chief Executive Officer (CEO) of a multibillion-dollar, multinational healthcare company. Born in Anthony to farmers of local stock, Neal Patterson maintained deep ties to the community.
“His parents were hardworking, blue-collar folks, and that’s really the fabric of the community – and that fabric was in his roots,” said Alan Patterson, Neal Patterson’s nephew.
Multiple times a year, Neal Patterson would return to his boyhood home, a farm near Manchester, Okla., minutes from Anthony, just across the state border. Each June, Neal Patterson could be found driving a combine on his family’s farm during wheat harvest.
The pace of life in Harper County differed from Kansas City, where Neal Patterson led Cerner Corporation, a health information technology company that, by 2013, had overtaken Sprint to become the city’s largest private employer.
On Neal Patterson’s trips home, Alan Patterson recalls how his uncle would sit on the family homestead porch in a rocking chair, working with a laptop and a couple of phones around him, surrounded by land his tenant-farmer parents had worked hard to acquire as their first farm.
Alan Patterson said when Neal Patterson and his brothers were young, they did not have indoor plumbing or heat, aside from a single propane heater. His parents worked hard to give their family a good life. Their father made sure the tractor didn’t stop until “one last round after sundown,” a saying that defined the family’s work ethic.
Neal Patterson graduated from Anthony High School in 1967 and raised livestock to put himself through college in Stillwater. After school, he took a job in Kansas City working in the emerging field of information systems consulting. In 1979, he and two others founded Cerner, which created clinical software for hospitals. By the mid-2010s, Neal Patterson was regarded as an industry pioneer and Cerner’s lead visionary. He was known for an ability to “see around corners,” often predicting events before they occurred.
It was that insight that made Neal Patterson uniquely suited to understand the drama playing out in Harper County’s hospitals. He knew the risk rural hospitals faced, and he grew concerned that Harper County’s dueling hospitals fit the pattern of organizations whose high-stakes fights for survival could leave them both vulnerable.
Having both hospitals fail would be a disaster. Gradually but persistently, he started conversations with local and regional healthcare leaders he knew. Through them, he got the word out that he would like to support a unifying solution that would improve the standard of rural care and protect healthcare access and jobs in the region.
Neal Patterson’s proactivity culminated on his 65th birthday, Dec. 10, 2014, when he addressed a letter to both hospital boards. On the stationery of his private family foundation, he challenged them to work together to study and then build a new, sustainable, and exemplary model of rural healthcare based on an understanding of the community’s holistic needs.
“In my opinion, a future sustainable model must be designed as a regional center which engages all the stakeholders in the community,” he wrote.
He understood that fears about costs could be a significant obstacle. In anticipation, he made his boldest promise. “Based on analysis findings,” he wrote, “it is my intention personally to become the lead private donor in the undertaking of the aforementioned new model of rural health care.”
He asked leaders to come together and find a solution with Cerner and Ascension Via Christi – a metro-Wichita hospital that formally accepted patients from both hospitals when their patients had specialized needs that could not be addressed locally.
He also offered resources to make it possible, including funding for independent analysis, access to Cerner’s expertise in operations and strategy, and support in navigating legal and financial complexities that came along the way.
“Today with information and medical technologies, it is possible to design a rural system with access to almost all of the care standards and specialty skills of a large national integrated health system – a system that helps right decisions to be made with the right skills at the right time,” Neal Patterson wrote to both hospital boards. “Simply speaking, lives will be saved, and more health care will stay in the community, which brings real economic benefits to the community.”
He asked Anthony to defer a project focused on existing facilities and give up an associated $400,000 Community Development Block Grant. He offered to mitigate the risk. If the necessary analysis later showed the new model wasn’t viable, Neal Patterson committed to reimbursing the hospital for lost funding and expenditures associated with pausing their independent pursuits.
The message was clear: It was time to stop thinking separately and start thinking together.
Although Neal Patterson had offered a bold community proposition, it required two longtime rivals to set aside decades of competition.
In our next story in the three-part series, you will find out if, and how, the two community hospitals came together to better serve the region and create a transformative rural healthcare model. Be watching the Patterson Family Foundation’s website and newsletter for the second and third stories in the series.
Acknowledgements:
This story is written in memory of Neal Patterson, who, alongside his wife Jeanne, founded the Patterson Family Foundation and whose vision laid the groundwork for the community to create a sustainable model of rural healthcare delivery in Harper County. It is also in memory of Kimberly Schrant, who served as Patterson Health Center board member and Harper Hospital board chairman, and project working group member.
Thank you to April Martin, Patterson Family Foundation Chief Legacy Officer, for contributing to the story and continuing to honor the legacies of Neal Patterson and Jeanne Lillig-Patterson.
Thank you to everyone who was interviewed: Lori Allen, Kristen Birket, Sandra Owen-Campbell, Jim Chromik, Crissa Foley, Jody Gragg, Jessica Hunt, Martha Hadsall, Lisa Mathes, Alan Patterson, and Sarah Teaff.
