Quality health care systems are important to a community’s health interests, but they also play an important role in a community’s economic vitality. This paper reviews somecontemporary challenges facing rural health care systems due to changes in the health care industry, the health insurance industry, the national economy, and reforms of social benefitprograms. Using Preston County, West Virginia as a case study, the paper illustrates the link between rural economic vitality and quality, accessible healthcare systems. Furthermore, thispaper demonstrates the need for active community involvement in local health care decisionmaking processes. It also provides a variety of methods that can be used to measure the economic impacts of health care systems in a rural county using the IMPLAN input-output program using Preston County hospitals and clinics as a case study