Starting in October 2012, the county began soliciting offers for affiliation with neighboring healthcare systems in order to cement Albemarle Hospital's position as the region's major medical facility. Limitations in some services and specialty providers had caused many prospective patients to seek services in the Hampton Roads or Greenville metro areas, leading to steady erosion of operating margins. Affiliation with a larger health organization would also provide increased buying power, improvements in equipment and facility investment as well as entice additional physicians to the area.