Solving Indiana's healthcare imbalance: Why the future is built on partnership

Indiana’s healthcare system is facing a growing imbalance—one that is becoming increasingly difficult to ignore. Across the state, patients, providers, and communities are feeling the strain of a model that no longer aligns with today’s realities. Demand for care is rising, the workforce is under pressure, and where patients live continues to shape the care they can access.

As Lainie Dean, chief of commercial partnerships at Parkview Health, put it, “The patterns we’re seeing in Indiana are not unique; they represent a much larger challenge for healthcare across the country.” It’s a signal that traditional models of care delivery are no longer keeping pace.

At the center of the issue is a fundamental question: How do we ensure that every Hoosier has access to high-quality care, regardless of geography?

Today’s imbalance is driven by a mismatch between need and capacity. Rural communities face limited access to specialty care, while advanced services are concentrated in a handful of urban hubs. At the same time, the healthcare workforce is shrinking in the areas where it’s needed most, even as demand rises, particularly among aging populations.

The result is a system under strain from both ends.

Patients in rural communities often travel long distances for care, delaying treatment or going without it altogether. Meanwhile, urban systems are operating at or near capacity, managing high volumes, long wait times, and growing levels of workforce burnout.

“This polarization is amplifying,” Dean said. “We have two systems pulling in opposite directions, overstressed urban systems and underserved rural communities. And we keep treating them as separate problems.”

They’re not. They’re two expressions of the same underlying imbalance—and solving it requires creative solutions.

At the same time, financial pressures are reshaping how healthcare organizations operate. Rising expenses and razor-thin margins are forcing leaders to reconsider long-standing growth strategies. The traditional model of expanding services, adding capacity, and competing on volume is becoming increasingly difficult to sustain.

“We have to think differently,” Dean said. “With limited capital, leaders need to explore how to partner to achieve desired outcomes.”

Technology is helping to bridge some of these gaps, but it is not a standalone solution. Tools like telehealth, remote monitoring, AI-enabled workflows, and integrated data systems are reshaping what’s possible, but their value depends on how they’re applied.

“Technology is not a substitute for the workforce,” Dean said. “It’s a multiplier.”

When implemented thoughtfully, it can extend access, improve coordination, and reduce unnecessary burden for patients. But without alignment across systems and care models, even the best tools fall short.

What’s emerging instead is a more intentional approach to healthcare, one that moves away from trying to be everything to everyone and toward designing systems that work together.

“The shift is about being purposeful,” Dean said. “Being clear on where you can deliver excellence, and just as clear about where you should partner.”

A critical part of that shift is recognizing that local access and regional excellence are not competing priorities; they are interdependent.

Patients need routine services such as primary care, diagnostics, and chronic disease management close to home. At the same time, highly specialized care requires concentrated expertise, advanced technology, and significant investment, making regional centers the right setting.

“The future isn’t about choosing one or the other,” Dean said. “It’s about building a system where both are connected and reinforce each other.”

That connection doesn’t happen by default. It is built through partnership.

Healthcare today demands a more coordinated approach. The combined pressures on workforce, cost, and complexity are not just challenges—they’re also driving a structural shift. No single organization can meet these demands alone, making partnership a fundamental requirement for delivering sustainable, high-quality care.

“Partnerships aren’t a sign of weakness,” Dean said. “They’re the rational response to the reality we’re in.”

When designed well, partnerships allow organizations to expand access, share risk, and bring new capabilities into communities more efficiently. They also create more connected patient experiences, something that is increasingly expected.

Patients today have clear expectations for their healthcare:

• Accessible and close to home

• Fast and convenient

• Digitally enabled

• High quality and affordable

Delivering all of that at once requires scale, and scale requires collaboration.

The implications extend beyond healthcare delivery. Access to reliable care is closely tied to economic growth, workforce development, and community stability. As Dean said, “Communities without strong healthcare systems struggle to attract residents, employers, and investment. This isn’t just about healthcare. It’s about the long-term viability of communities.”

Looking ahead, the direction is clear. Healthcare will become more integrated, more regional, and more collaborative. Virtual care will expand, outpatient models will grow, and workforce strategies will increasingly rely on coordination rather than competition.

“The future of healthcare in Indiana is not rural versus urban,” Dean said. “It’s rural and urban working together through integrated networks.”

Success will depend on organizations remaining adaptable, collaborative, and deeply attuned to the communities they serve. By doing so, they can ensure that innovation not only advances healthcare but also makes it more accessible for everyone.

Through its work with forward-thinking health systems like Parkview Health, UpVia Health is helping bring this vision to life—supporting partnership-driven models that expand access, strengthen local care networks, and connect communities across the full continuum of care.

Because solving healthcare’s biggest challenges won’t come from going it alone. It will come from building the right connections between systems, communities, and the patients they serve.