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 — a number that has since grown to 107. For Harper County residents, the implications were clear: one or both could close, leaving the closest assistance 30 miles away.

A System Under Pressure

Both hospitals had deep roots in their communities. Built in the 1960s, they were more than healthcare providers; they were economic drivers and symbols of local identity. Residents supported them not only as patients but 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. Patient volumes fluctuated, and both hospitals experienced low utilization rates of 30–35% compared with state and urban Wichita averages of 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. 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.

There was no turning away from it; the assessment formalized what everyone had been feeling. Although change was overdue, the prospect of change was frightening. Across rural America, competitive dynamics in healthcare often play out as competitors weaken themselves while waiting for the other to fail first.

A Bold Offer from an Unexpected Source

One person asking this exact question was the Chief Executive Officer of a multibillion-dollar, multinational healthcare company. Born in Anthony to farmers of local stock, Neal Patterson maintained deep ties to the community.

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, he could be found driving a combine on his family's farm during wheat harvest. The pace of life in Harper County differed sharply from Kansas City, where he led Cerner Corporation, a health information technology company that by 2013 had overtaken Sprint to become the city's largest private employer.

On those 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.

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, he was regarded as an industry pioneer and Cerner's lead visionary — known for an ability to "see around corners," often predicting events before they occurred.

It was that insight that made him 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.

December 10, 2014

Having both hospitals fail would be a disaster. Gradually but persistently, Neal Patterson started conversations with local and regional healthcare leaders he knew. He got the word out that he would like to support a unifying solution — one that would improve the standard of rural care and protect healthcare access and jobs in the region.

On his 65th birthday — December 10, 2014 — Neal Patterson 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.

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 facilities when specialized needs could not be addressed locally. He also offered resources to make it possible: funding for independent analysis, access to Cerner's expertise in operations and strategy, and support in navigating the legal and financial complexities that came along the way.

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, he committed to reimbursing the hospital for lost funding and all associated expenditures.

The message was clear: it was time to stop thinking separately and start thinking together. Although Neal Patterson had made a bold community proposition, it required two longtime rivals to set aside decades of competition. The story of what came next — of how Harper County answered that challenge — became the foundation of Patterson Health Center as it exists today.