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However, these tactics seem diametrically opposed to improving revenue and building patient loyalty. Cost reduction can be accomplished by reducing staff, reducing the number of services offered, or reducing the amount of time spent with patients. Providers must work to both reduce the cost of providing care and employ mechanisms to increase revenue. More than 200 rural hospitals are at immediate risk of closure, and nearly 30% of rural hospitals nationwide are at risk of closing in the near future. According to a report, hundreds of rural hospitals across the United States are teetering on the edge of closure, with their financial status increasingly in peril. Healthcare providers are facing increasing expenses and flat (or even decreasing) reimbursement rates, creating a major challenge for healthcare providers as they try to provide the care their communities require.