Navigating provider compensation in rural health care
Provider compensation is a topic that consistently challenges rural health care organizations. Whether it’s navigating pay variability, aligning incentives with performance, or keeping up with compliance, the stakes are high. The 2024 Rural Provider Compensation Report by Stroudwater Associates Principal Opal H. Greenway in partnership with NRHA and National Office of State Offices of Rural Health offers critical insights to help rural hospitals address these issues thoughtfully and strategically.
This report reflects input from 199 organizations across 42 states, representing more than 2,800 providers. The data paints a clear picture of the current landscape and highlights areas where rural hospitals must adapt to remain competitive and sustainable.
Key findings
Here are some takeaways that stand out:
- Incentives remain uncommon: Over half of surveyed rural organizations (54.7 percent) pay providers straight salaries without tying compensation to performance or quality metrics.
- Compensation varies significantly: Total compensation for family medicine physicians without OB ranges widely, from $179,500 to $420,874.
- Uncertainty around fee schedules: Only 36.8 percent of respondents are using the most recent Medicare physician fee schedule, with many unsure which version they are using.
- CRNA pay increases sharply: Median salaries for CRNAs have risen to over $251,500, significantly outpacing inflation and other specialties.
What does this mean for rural hospitals?
These findings underline the importance of having access to reliable, actionable data when shaping compensation strategies. As Greenway explains, “Provider compensation in rural hospitals poses distinct challenges compared to urban and suburban organizations, emphasizing the need for accurate, applicable data.”
NRHA CEO Alan Morgan further emphasizes, “Understanding the unique compensation needs of rural health care providers is essential — not just for their success, but for the long-term sustainability of rural health care systems.”
If rural hospitals don’t address compensation issues proactively, they risk financial instability and compliance challenges that could hinder their ability to deliver care effectively.
What’s new in this year’s report?
The 2024 edition expands on the inaugural report, offering deeper insights into provider compensation benchmarks. It provides data for primary care providers, nurse practitioners, physician assistants, and specialists in key areas such as cardiology, general surgery, and orthopedics.
The report isn’t just about numbers — it’s about equipping rural health care leaders with the information needed to make informed decisions that support their organizations’ missions.
Download the report
The 2024 Rural Provider Compensation Report is now available for download. Whether you’re managing recruitment, compliance, or organizational strategy, this report is a valuable resource to inform your decision-making.
By participating in future surveys, you can help ensure these insights continue to reflect the realities of rural health care. Let’s work together to address these challenges and strengthen the foundation of rural hospitals.
NRHA adapted the above piece from Stroudwater Associates, a trusted NRHA partner, for publication within the Association’s Rural Health Voices blog.
 | About the author: Opal Greenway is an accomplished health care and finance professional who focuses primarily on the strategic needs of health care service providers. For over a decade, Opal has focused on assisting physicians, hospitals and health systems around provider strategy, engagement and alignment. Her advisory practice addresses the strategic and operational needs in physician practices, ambulatory development, compensation, valuations, capital planning, transactions and regulatory compliance. |