Joanie Perkins boarded a plane this past week and flew to Washington D.C. to meet with Administrator of the Centers for Medicare & Medicaid Services Dr. Mehmet Oz.
Meetings like that are nothing new for the Ruleville-based health care advocate.
Perkins, who serves as North Sunflower Medical Center’s chief compliance officer, is the 2025 recipient of the National Rural Health Association’s Louis Gorin Award for Outstanding Achievement in Rural Health Care.
Perkins has been advocating for rural hospitals and clinics for decades, the last 18 years at the Ruleville-based hospital, where she continues to find revenue streams for the county-owned facility, even as federal funding has contracted.
She said that she had not been aware that she was a nominee for the Gorin award until she was contacted by NRHA to notify her that she had won.
“It was very humbling to get that, because these are my colleagues,” Perkins told The Enterprise-Tocsin. “We go advocate together. I thoroughly enjoy taking our stories to our legislators. I’ve ended up being the state (NRHA) contact, and I get asked to speak a good bit on rural issues and try to find ways to help people survive.”
It was during a speaking event at a St. Louis conference nearly 20 years ago when the late Billy Marlow heard Perkins talking about survival in rural medicine. Then the executive director of NSMC, he offered her a job.
She accepted, committing initially only to five years.
Since then, Perkins has made Mississippi her home, and she is more dedicated than ever before to rural medicine advocacy.
“It’s tougher and tougher, honestly,” Perkins said. “Our slice of the pie gets smaller. Sequestration took away 2%. We’re supposed to be getting 101% of Medicare, and we don’t even get that now.”
Prior to joining the NSMC staff in 2007, Perkins worked with the NRHA in Indiana, where she had worked with Ascension Healthcare.
Whether in the Midwest or the Delta, Perkins’s focus has always been on making sure that rural hospitals and clinics do not suffer from collateral damage in D.C.’s political battles over health care.
The passage of what is known as the “Big Beautiful Bill” has a number of implications, some possibly good and some problematic for rural hospitals, including cuts to Medicaid that could impact hospitals in the Delta region.
“We’re definitely going to go over some things in the Big Beautiful Bill that may not be too advantageous for rural America,” Perkins said prior to her Tuesday meeting with Dr. Oz.
A potential positive from the bill for rural hospitals is a $50 billion appropriation over the next five years for a “rural health transformation program,” Perkins said.
Perkins said that Mississippi, which is considered 38% rural, will receive a substantial cut of that funding, and she said that NSMC will apply for money when the applications become available later this year.
In the meantime, the Medicaid work requirement may have a significant impact on hospitals like NSMC.
“I think that’s going to really impact us, I really do, in the state of Mississippi, I feel like the 80 hours of work that people have to prove for eligibility, we may get a lot of Medicaid folks off the rolls,” Perkins said.
The Congressional Budget Office estimates that the work requirement may save the federal government over $300 billion over the next decade, while also increasing the number of people without the social safety net.
“It’s scary, because, especially for rural (hospitals), where are they going to go?’ Perkins said. “They’re going to end up coming here anyway. For us, it’s uncompensated care…Nobody wants to do that. We can’t afford to run for free.”
Perkins also expressed a need for caution when it comes to the recent rise in Medicare Advantage Plans, something of which she said Dr. Oz has been a proponent.
“Hospitals like North Sunflower are cost-based reimbursed, only on the percentage of Medicare patients they have,” Perkins said. “When a patient switches to a Medicare Advantage Plan, that’s no longer considered a Medicare beneficiary. They are now considered a commercial carrier. Our percentage keeps going down.”
Meanwhile, Perkins said that NSMC continues trying to find creative funding mechanisms, rooted mostly in partnerships that have made the hospital profitable.
“Our partnerships have kept us sustainable, but it is harder and harder to make it,” she said.
Perkins said that meetings like the one she had this week with Dr. Oz may help folks on the federal level better understand the plight of struggling hospitals in regions like the Delta and other rural places.
It also gives her a chance to make new contacts, expanding her reach and her ability to advocate.
That is what earned her the Gorin award, and that is what she hopes will result in more sustainable hospitals and clinics in rural America.
