Eight more hospitals and an insurance company are the latest to join the Pennsylvania Rural Health Model, an initiative aimed at ensuring the financial health of rural hospitals across the state.

The first of its kind in the nation, the model is intended to help rural hospitals, which are often an economic driver in rural areas, stay open, that jobs stay local and that sustainable access to health care is available to residents living in rural areas.

Nearly half of all rural hospitals in Pennsylvania are operating with negative margins and are at risk of closure, Gov. Tom Wolf said in a news release.

The governor recently signed Senate Bill 314, which establishes the Rural Health Redesign Center Authority and the Pennsylvania Rural Health Redesign Center Fund.

The authority and fund will administer the Pennsylvania Rural Health Model once established.

The latest to join the model are ACMH Hospital near Kittanning, Chan Soon-Shiong Medical Center at Windber in Somerset County, Fulton County Medical Center in Fulton County, Greene Hospital in Greene County, Monongahela Valley Hospital in Washington County, Punxsutawney Area Hospital in Jefferson County, Tyrone Hospital in Blair County and Washington Hospital in Washington County.

The first five participants announced earlier this year are Barnes Kasson, Endless Mountains, Geisinger Jersey Shore, UPMC Kane and Wayne Memorial.

Aetna will join the five insurance providers previously announced as private insurance payers for the model.

The others are Gateway, Geisinger, Highmark, Medicare and UPMC.