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States With the Most Rural Hospital Closures [1]

['Steven Ross Johnson', 'June', 'At P.M.']

Date: 2023-11

The ongoing spate of rural hospital closures in the U.S. threatens many Americans’ access to vital health care services.

A total of 195 rural hospitals have shut down since 2005, according to data compiled by the University of North Carolina’s Cecil G. Sheps Center for Health Services Research, including 100 hospitals that have shuttered their doors completely and 95 facilities that no longer provide inpatient services.

More than 60 million Americans live in rural areas, and they are generally older in age and more likely to be in poorer health compared with people living in more urban areas. Rural residents can face less access to health care services and have to travel greater distances to receive care when a facility closes. Prior research indicates a potential relationship between traveling farther to receive health care and poorer health outcomes.

Overall, more than 600 rural hospitals – nearly 30% of all rural hospitals in the country – were at recent risk of closing due to financial pressures, according to 2023 data from the Center for Healthcare Quality and Payment Reform.

As of June 22, a total of 11 rural hospitals had closed in 2023, according to the Sheps Center. Since the beginning of the COVID-19 pandemic in March 2020, 35 rural hospitals had shut down, with 14 of those closures occurring in 2020.

The 10 states with the most rural hospital closures account for 60% of total rural hospital closures in the U.S. since 2005, with nearly a quarter of closures among the top 10 occurring in Texas alone. All but three of the 10 states had not implemented Medicaid expansion as permitted under the Affordable Care Act to increase insurance coverage.

The Sheps Center defines a rural hospital as a “short-term, general acute, non-federal hospital” that’s either located outside of a metropolitan county, certified as a critical access hospital or located in a U.S. Department of Agriculture Rural-Urban Commuting Area with a classification code of 4 or higher.

Here are the 10 states with the most rural hospital closures since 2005. Closures can include facilities that have shuttered completely and ones that no longer provide inpatient care. Population figures were pulled separately by U.S. News from the 2020 decennial census.

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[1] Url: https://www.usnews.com/news/healthiest-communities/slideshows/states-with-the-most-rural-hospital-closures

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