By Tim Gronniger, CEO, Hopscotch Primary Care
For residents and families across Western North Carolina, Hopscotch has become a familiar name—a testament to the deep roots we have built, and the meaningful progress we have made within the communities we serve there.
The idea behind Hopscotch is not complicated. Rural patients deserve the same access to an actual physician, an actual nurse practitioner, and a team who knows them that patients in cities have taken for granted for decades. What is complicated is actually building that access. That is the problem Hopscotch set out to solve four years ago, it is the promise we are delivering, and it is the opportunity our recent funding round allows us to keep growing to a much greater scale.
A crisis hiding in plain sight
Rural health care has absorbed decades of disinvestment. Hospitals have closed. Physicians have left—or never arrived in the first place. Solo practices, the backbone of primary care in small towns for generations, are disappearing because younger physicians cannot practically take them over. Nearly 90 percent of rural America sits inside a federally designated health care professional shortage area. For too many families, the default plan for primary care is no plan at all: a long drive to a hospital, or a trip to the emergency room for something that never needed to become an emergency.
This is not a niche issue. About 20 percent of the country lives in rural America, and roughly 400 billion dollars in health care spending flows through rural communities every year. Yet very few companies have been built to actually meet patients where they live. Most rural health strategies I have seen start with a workaround: a virtual-first model, or a thin layer of enablement services wrapped around a clinic already operating on the brink. Almost none of them start by solving the hardest part of the problem, which is connecting a dedicated physician, or nurse practitioner, or physician’s assistant with the patient.
Starting with the hard part first
Hopscotch started there on purpose. We directly employ and hire the physicians, nurse practitioners, and physician assistants who staff our clinics, and we support them with strong teams and modern tools: AI-enabled workflows, virtual specialty consults, telehealth, and real-time visibility into what is happening with their sickest patients. We now operate 12 clinics across Western North Carolina, serving more than 15,000 patients. In many of our communities, we are the primary access point for sick seniors who would otherwise have nowhere reliable to turn. When Helene cut off much of Western North Carolina, our teams responded with urgency, re-opening within days, and creatively pitching in to support our patients and our neighbors alike.
We have also learned that recruiting physicians to rural communities is not the impossible task people assume. The retirement wave among rural family physicians is a crisis, but it is also an opening. We have built a model that helps late-career physicians transition out of solo practice gracefully, while giving a new generation of clinicians a reason to move to, or commute into, a rural community: a team-based practice focused on patient outcomes, technology that actually makes their job easier and more productive, and fair compensation – often supplemented by federal and state loan forgiveness and other workforce programs. We have recruited physicians from the Research Triangle, from Charlotte, California, the Northeast, Virginia, and Oklahoma. The demand is there. What has been missing is an employer worth saying yes to.
Why this funding round matters
We are proud that we have recently closed a $53 million round, an inflection point for Hopscotch. Fewer companies are willing to take on the challenges of directly providing primary care than five years ago, and that’s why we’re so proud of our work to date, and excited by the opportunity in front of us. We have shown that rural primary care, delivered directly and operated with discipline, can work and can work profitably. Our clinics reach profitability in roughly 14 months, far faster than the historical norm for practices like ours. Disciplined operations and profitable operations are a prerequisite for creating a sustainable model, and that’s what we’re delivering. To serve patients and serve them well, the economics must work for all stakeholders in the healthcare ecosystem.
We are reducing medical expenditures and helping patients avoid unnecessary hospitalizations at a pace that compares favorably to the best-run practices in the country, urban or rural. And we do it while spending a fraction of what urban primary care groups typically spend to bring in new patients, because the need in our communities is so acute that patients come to us. This funding gives us the ability to take a model that is working in Western North Carolina and bring it to more of the country. We expect to open new capacity in 2027, with more detail to come as those plans take shape.
What comes next
Our vision for Hopscotch over the next two years is straightforward: continue to be the best primary care option in rural America, full stop, and build a company that clinicians and business professionals alike are proud to be part of. Rural America does not need another pilot program or another vendor promising to fix things from a distance. It needs organizations willing to hire the people, build the infrastructure, and stay. That is what we intend to keep doing, in more communities, for more patients, for as long as it takes.