Open Competition — One-Week Design Sprint

Rural Health Transformation
Competition

Design a financially sustainable primary-care operating model for a fictional low-volume clinic in Challis, Idaho — beginning with a modeled $1.5M transformation launch grant. Your model must work after the grant is gone.

Presented by Idaho Advanced Consulting in partnership with Cornerstone Whole Healthcare

Submissions close — Friday, September 11, 2026 at 7:00 PM

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Awards

Cash Prizes

Top submissions receive cash awards. Prizes are paid to the team lead following winner notification.

1st Place
$600
First Place Award

Best overall submission judged on financial rigor, originality, research quality, and implementation feasibility.

2nd Place
$200
Second Place Award

Strong submission demonstrating solid analysis, credible financial modeling, and a realistic operating model.

3rd Place
$50
Third Place Award

Notable submission showing creative thinking and evidence-based research with a viable approach to rural sustainability.

Ready to Compete?

Submit Your Solution

Review and accept the competition terms and conditions to unlock the submission form. The Google Form link opens immediately after you agree.

The submission link opens after you read and accept the terms and conditions.

The Problem

Why Rural Primary Care Fails — and Why It Matters

Rural primary care clinics operate under a structural disadvantage that good intentions alone cannot fix. The cost of keeping a clinic open — licensed staff, compliant space, medical technology, malpractice insurance, billing systems — is largely fixed regardless of how many patients walk through the door each week. In a community like Custer County, Idaho, that math rarely works without external support. The result is clinic closures, patients driving two or more hours for routine care, delayed diagnoses, and communities left medically isolated.

~170
Rural hospitals closed in the U.S. since 2005, with dozens more at financial risk each year
60%
Of rural U.S. counties are federally designated Primary Care Health Professional Shortage Areas
4,100
People in Custer County, Idaho — the full service area a Challis clinic would realistically serve
$276K+
Annual overhead in the Challis case — rent, EHR, outreach van, billing — before any provider salary
64%
Of the Challis payer mix is Medicaid and Medicare, which typically reimburse below the cost of care
$1.5M
Modeled transformation launch grant — the launchpad your team must build a self-sustaining model around
01
The Fixed-Cost Trap
A rural clinic needs compliant space, malpractice insurance, an EHR system, medical supplies, and administrative staff whether it sees 8 patients or 80 per day. With Custer County's population spread across an area larger than Connecticut, daily volume will never approach what an urban practice considers normal. Fixed costs do not shrink to match low volume — they consume a larger share of every dollar collected until the clinic operates at a loss.
02
Workforce Scarcity
Recruiting licensed providers to rural Idaho is one of the most persistent challenges in healthcare. FNPs, PAs, and physicians with rural experience are in national short supply. Those willing to practice in remote settings face student loan debt, professional isolation without specialist backup, and lifestyle tradeoffs. Recruiting a single qualified FNP for Challis may require signing bonuses, housing support, and loan repayment assistance — all before the first patient visit.
03
Reimbursement Gaps
The Challis case reflects a realistic rural payer mix: approximately 38% Medicaid, 26% Medicare, and a meaningful share of uninsured patients on a sliding fee scale. Idaho Medicaid reimbursement historically runs below the actual cost of care. When the majority of visits are reimbursed at rates that do not cover fixed overhead, sustainability requires either volume the community cannot provide, supplemental revenue streams, or a fundamentally different operating model.
04
The Grant Dependency Cycle
Federal grants and state programs provide critical startup capital but create dangerous dependency if the underlying operating model never becomes self-sustaining. Many rural clinics cycle from grant to grant with no durable revenue plan. When a grant ends, so does the clinic. This competition exists to break that cycle — to use the $1.5M transformation grant as a launchpad, not a lifeline.
05
Distance and Access Barriers
Patients in Custer County may drive 60–90 minutes for specialty care in Idaho Falls or Twin Falls. Even routine primary care becomes a half-day commitment, discouraging preventive visits, delaying chronic disease management, and pushing patients toward the emergency room as a primary care substitute — at far higher cost to the system. Any viable model must account for how patients actually reach care, not just how care is theoretically available.
06
Technology and Administrative Burden
Modern healthcare requires expensive infrastructure regardless of clinic size: EHR systems with telehealth capability, billing systems that handle complex payer rules, credentialing for each insurance panel, and compliance with HIPAA, OSHA, and state licensing. A solo rural clinic carries these fixed administrative costs with a fraction of the volume that makes them economical in urban settings. Shared services, regional partnerships, or FQHC designation can help distribute this burden.

Resources

Submission Requirements & Downloads

Download the competition materials before you begin. You are not required to use the dataset — it is provided as context to help you understand the financial realities of a low-volume rural clinic. Your submission should be grounded in independent research, credible Idaho-specific sources, and your own financial modeling.

Minimum requirement: One primary narrative document of at least three full pages (excluding cover, references, and appendices), plus supplemental files that strengthen your submission.

Synthetic Dataset — Excel WorkbookOptional
618-encounter Challis clinic model with financials, payer mix, staffing costs, overhead register, and a live calculator tab
AGENTS.md — AI Research Guide
A structured prompt guide for using AI tools effectively in research, financial modeling, analysis, and drafting
Participant GuideRead First
Competition overview, evaluation rubric, submission requirements, judging criteria, and timeline
Full Competition Package — ZIP
All files bundled: Excel dataset, participant guide, AGENTS.md, codebook, and supplemental CSVs

Submission Requirements

What Your Team Will Build

A strong entry goes beyond identifying the problem. It proposes a specific, evidence-based operating model, demonstrates financial plausibility, cites Idaho-specific sources, and defines an implementation path that holds up after the grant period ends.

3+ Page Narrative
A clear problem statement, your proposed solution, and a concrete implementation plan with 90-day and 12-month milestones. Minimum three full written pages, excluding cover, references, and appendices.
Financial Model
How startup capital will be deployed from the $1.5M grant, what recurring revenue will sustain operations, what costs look like year-over-year, and a credible pathway to break-even without another large grant.
Cited Research
Every material external claim must be cited. Research should inform a specific Challis or Idaho decision, not serve as a generic rural health background section. Quantify only what your sources actually support.
Supplemental Files
Working Excel models, presentation slides, annotated maps, staffing Gantt charts, workflow diagrams, or any evidence that strengthens your argument. Supplemental files are strongly preferred.
AI Disclosure
If you used AI tools — ChatGPT, Gemini, Claude, Copilot — disclose which tools and how in a short appendix or methods note. AI-assisted work is allowed; unedited AI output is not.
Risk Analysis
What are the top two or three things that could cause your model to fail? What would you do differently if patient volume is 30% lower than projected, or a key provider leaves in year one?

Frequently Asked Questions

Common Questions

New to healthcare or rural health economics? These answers are designed to give every participant — regardless of background — enough context to do strong, original research.