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In North Dakota, references to the Rough Riders — a famed cavalry in the 1898 Spanish-American War — abound. The name graces hotels, grocery stores, and golf tournaments and has become a shorthand symbol of rugged individualism, bravery, and the willingness to act. A mix of cowboys, ranchers, Native Americans, and athletes from Ivy League schools, the Rough Riders burnished their reputation by volunteering to take on a heavily defended enemy and winning. Their improbable victory marked a turning point in the war and captured the public’s imagination to such an extent that it catapulted one of the regiment’s leaders — Theodore Roosevelt, a North Dakota rancher — into the White House.
A century later, the Rough Rider High-Value Network is echoing its namesake’s heroics by demonstrating to rural communities and hospital leaders that they may be underestimating their strengths. The network was formed in late 2023 when the CEOs of 23 critical access hospitals — many in sparsely populated frontier towns — came together to brainstorm ways of maintaining local control as hospitals around them were acquired by regional health systems. To preserve their independence in a marketplace dominated by rapidly consolidating health plans and health systems, they figured they needed to match these entities’ scale. Otherwise, they feared they’d have to cede more ground — and a greater share of health care resources — to them.