Addressing the Future of Rural Healthcare: Inside the 2026 Fleming Center Case Competition
The Fleming Center Case Competition, hosted by The Board and the George McMillan Fleming Center for Healthcare Management, returned this spring with a full day of high energy, sharp thinking, and collaborative problem-solving at UTHealth Houston School of Public Health.
Held on April 11, the 16th annual in-person competition brought together 40 students from universities across the country to tackle a complex, real-world healthcare challenge.
This year’s case, “When One Hospital Is All That’s Left,” focused on the growing fragility of rural health care systems. Participants were asked to evaluate regions in East Texas where access to care is increasingly at risk due to hospital closures, workforce shortages, and shifting federal policies. Teams analyzed how rising uninsured rates, increased emergency department demand, and financial strain on rural hospitals could affect long-term sustainability and developed strategic, data-driven solutions to improve access and strengthen regional healthcare systems over the next five years.
Throughout the day, the atmosphere was both competitive and collaborative. Teams worked to build compelling recommendations and present their findings to a panel of experienced health care leaders. The level of preparation was evident across the teams, with students demonstrating not only technical knowledge, but also the communication and teamwork skills essential to health care leadership.
After an impressive round of final presentations, UTHealth Houston earned first place and a $2,000 prize. The UTHealth Houston team, captained by Vivian Ton and team members Colleen Macke, Ritika Sharma, and Alijah James, and supported by faculty advisor Bryan Schneider, DHA, FACHE, FACMPE, stood out for their clear, actionable approach to stabilizing care delivery in a high-risk environment. Their proposal is centered on a regional care coordination model that leverages community health workers and non-emergency medical transportation to improve access, reduce strain on emergency services, and create a more sustainable system for both patients and providers.
Texas Woman’s University secured second and third place. The second-place team proposed a structured, long-term redesign of regional healthcare delivery, combining a hub-and-spoke care model with telehealth and workforce partnerships to address provider shortages and improve access across underserved areas. The third-place team focused on a hybrid model that integrates telehealth, mobile clinics, and workforce development strategies to strengthen chronic disease management and build a more resilient rural health system over time.
The competition was evaluated by a distinguished panel of industry leaders who brought deep expertise and practical insight into the judging process:
- Jose Rodriguez, MHA, FACHE, FAHRA, CRA, CPHQ - Harris Health Ben Taub Hospital
- Gerald (Jerry) R. Ledlow, PhD, MHA, LFACHE - University of Texas at Tyler
- Ifeoluwa R. Malmberg, MD, MPH - Baylor College of Medicine
- Raman Singh, DHA(c), FACHE, NEA-BC, CENP, CSSGB, CPHQ - Frontera Healthcare
- Robert Gonzalez - RevOPS
- Sahar Mazhar, PharmD, MPH - S2S Care
- Nate Grise - Health Connect TX
With participation from institutions including the University of Houston Clear Lake, University of Oklahoma Health Campus, UTHealth Houston, Virginia Commonwealth University, Texas Woman’s University, and Prairie View A&M University, the event displayed a wide range of perspectives and approaches to solving today’s healthcare challenges.
More than just a competition, the Fleming Center Case Competition continues to serve as a hands-on learning experience, allowing students to apply classroom knowledge to real scenarios, strengthen critical skills, and connect with peers and professionals across the field.