Rural hospital closures in the United States hit their highest level in a decade last year, with 19 facilities shutting down, according to a new report by the Chartis Center for Rural Health. The analysis found that 120 rural hospitals have closed since 2010, with southern states such as Texas, Tennessee, and Oklahoma most affected.
The report noted a slowdown in closures during 2016 and 2017, but the trend reversed, with 34 closures in the past 24 months. Researchers identified 453 rural hospitals currently at risk of closure, using a model that assesses vulnerability factors.
A key factor is Medicaid expansion: hospitals in states that have adopted the expansion are 62% less likely to close. However, states like Texas have refused federal funding covering 90% of expansion costs, leaving many facilities with lower operating margins and greater vulnerability.
The closures have become a political issue in rural America, where healthcare access is already limited amid the opioid epidemic. Leading Democratic presidential candidates have supported expanding government-assisted healthcare to address the problem.
The report warns that the crisis may worsen, as states with the highest closure rates also face the greatest vulnerability, threatening to further erode local healthcare services.
