Description

Episode Overview

Rural healthcare doesn’t operate on scale — it operates on access.

In this episode of the Madison Advisory AI Podcast, Amanda Verner Thompson sits down with Diane Moore, Chief Financial Officer of Mitchell County Hospital in West Texas, for a grounded conversation about leadership under constraint.

Diane shares what it really means to operate a rural hospital in a town of 3,000 people serving an area of 11,000 — from staffing cliffs and provider shortages to behavioral health gaps and the structural mismatch in reimbursement models.

They discuss:

• Why rural hospitals operate under fundamentally different economic physics
• The looming provider retirement cliff
• Telehealth as both lifeline and limitation
• The strain of multiple EMR and systems transitions
• Revenue cycle pressure and Medicare Advantage challenges
• How low utilization breaks traditional reimbursement models
• Where AI is already helping — and where accuracy matters most

At the center of the conversation is one clear thesis:

Rural hospitals aren’t about volume. They’re about access.

And when a rural hospital closes, the entire community feels it.

Key Themes

• Staffing challenges beyond nursing
• Innovative recruitment and partnership strategies
• Behavioral health access gaps
• Financial sustainability under Medicare Advantage
• The economics of low utilization
• AI as a practical teammate in reporting, claims analytics, and grant management
• Leadership, innovation, collaboration, and heart

Chapters

00:00 – Why Rural Healthcare Operates Differently
03:00 – Staffing Beyond Nursing & The Provider Cliff
07:30 – Behavioral Health Gaps & Telehealth Tradeoffs
11:30 – ER Perception and Patient Transfers
14:30 – Technology Transitions Under Constraint
17:30 – Revenue Cycle Pressure & Medicare Advantage
21:00 – Low Utilization and the Reimbursement Mismatch
24:30 – Where AI Is Actually Helping
27:00 – Innovation, Collaboration, and Heart

About the Guest

Diane Moore is the Chief Financial Officer of Mitchell County Hospital in West Texas. She has spent her career operating inside rural and community hospitals across Texas and Arizona, serving in both CFO and CEO roles. Diane is deeply passionate about preserving access to care in rural communities and advocates for fair reimbursement models that reflect the true economics of rural healthcare delivery.

Connect with Diane:
LinkedIn: https://www.linkedin.com/in/diane-moore-8a275617/

About the Host

Amanda Verner Thompson is the Founder of Madison Advisory AI and a former healthcare investment banker with nearly two decades of experience advising hospitals, health systems, behavioral health providers, and healthcare services organizations.

Through Madison Advisory AI, Amanda works with founders, operators, and investors to bridge the gap between insight and execution — combining seasoned advisory judgment with intelligent, practical systems.

Website: https://www.madisonadvisory.ai/

LinkedIn: https://www.linkedin.com/in/amanda-verner-thompson/

Listen & Subscribe

Available on Apple Podcasts, Spotify, YouTube, and wherever you listen to podcasts.