The State of Rural Healthcare
The state of rural healthcare in America has reached a critical tipping point, with nearly half of rural hospitals operating in the red and 432 facilities vulnerable to closure. According to the Chartis report, these stark numbers represent more than just statistics – they reflect a growing crisis in healthcare access for over 46 million Americans living in rural communities.
Since 2010, 182 rural hospitals have either closed their doors completely or converted to models that no longer provide inpatient care. This represents approximately 10% of the nation's rural hospitals, creating what healthcare experts call "care deserts" across vast stretches of rural America. The impact is particularly severe in states like Texas, which has lost 26 facilities, and Tennessee, which has seen 16 closures.
The financial pressures these hospitals face are multi-faceted. Government policies like sequestration (a 2% cut in Medicare reimbursement) will cost rural hospitals more than $509 million in 2025 alone and result in over 8,000 lost jobs. Additionally, changes in bad debt reimbursement will strip away another $159 million from rural hospital revenues.
Even more concerning is the deteriorating access to specialized care. Between 2011 and 2023, 293 rural hospitals stopped providing obstetric services – representing nearly a quarter of all rural OB units. Similarly, 424 facilities ceased offering chemotherapy services between 2014 and 2023. For rural residents, this means traveling greater distances for essential medical care, often in emergency situations.
The challenges extend beyond just hospital operations. Rural communities show troubling health disparities compared to their urban counterparts:
Rural residents face higher rates of adult obesity (66th percentile vs. 36th percentile in urban areas)
Higher rates of premature death (62nd percentile vs. 42nd percentile)
Higher suicide rates (69th percentile vs. 37th percentile)
Lower median household income (32nd percentile vs. 68th percentile)
Of particular concern is the impact on rural veterans, who make up nearly 25% of all veterans. With many rural hospitals vulnerable to closure and services being cut, these veterans face increasing challenges in accessing both routine and specialized care.
The report suggests that stabilizing the rural health safety net will require both immediate financial relief and long-term solutions to address population health trends. While some positive steps have been taken, such as the Rural Emergency Hospital designation that has helped preserve healthcare services in 32 communities, more comprehensive solutions are needed to ensure the survival of rural healthcare facilities and the communities they serve.
Source: "2025 rural health state of the state" report by Chartis Center for Rural Health (2025).
