Advocates say that with 1.5 million Mississippians visiting these 175 hospitals and 34 clinics each year, it is vital to ensure their survival. Last year, Gov. Phil Bryant declared Nov. 20 Mississippi Rural Health Day. The University of Mississippi Medical Center, and the Mississippi Rural Health Association announced awards this year to recognize rural doctors and facilities that have demonstrated excellence in rural health. They are a crucial part of Mississippi’s healthcare system. Ryan Kelly, executive director at the Mississippi Rural Health Association, said that they serve more than half of the state. It’s difficult to see the financial problems in rural health news. Rural hospitals are being regulated and subject to so many restrictions. “Uncertainty has been the rule for 8-10 years.” This trend is highlighted in the quarterly publication of the Mississippi Rural Health Association. A recent issue contains a notice regarding the closure of Quitman County Hospital. A brief announcement states that Community Health Systems is selling three Mississippi rural hospitals as part of a debt reduction effort. Kelly says that there are many issues. Many of these issues can be traced back at the increased regulation with the Centers for Medicare & Medicaid Services and Mississippi’s Managed Care Organizations. Nearly 60% of rural patients are eligible for Medicaid or Medicare. CMS takes up to eight to nine months to credential a doctor. This is due to regulatory backups. If a doctor isn’t reimbursed, it can take eight to nine months. Large hospitals usually have the cash reserves to make up for this delay. Kelly stated that a rural clinic would not be able (or even close to) being able to accomplish this task. It’s difficult for them to cope with the regulatory burdens, changes coming in, both good and bad, as well as the associated costs. Rural health is more affected by all this,” Kelly said. Kelly also mentioned that there are increased requirements for case management and quality reporting, which requires more staff. Even large urban hospitals can find it difficult to afford the cost of updating their electronic medical records. In August, merger talks began between Memphis and Jackson Baptist Healthcare Systems. According to a press release the main incentive for the deal is the expansion of the Jackson hospitals’ medical records system. The Mississippi Rural Health Association hosted a reception on Friday to honor 37 rural clinics and 12 rural hospital for “outstanding quality” in honor of Mississippi Rural Health Day. Kelly stated that providers and facilities face enormous demands and should be praised and rewarded for meeting and exceeding these measurable goals. The Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, named Dorothy Grady Scarborough the Rural Health Champion 2016. Scarborough, a registered nurse, is the founder of Mississippians Engaging in a Greener Agriculture and the co-leader of Mississippi Farm to School Network. This network focuses on nutrition in schools.