10 states with the most hospital closures, biggest net gains

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A total of 743 general acute-care hospitals have closed across the United States since 2000, according to a July 22 news release from the Health Care Affordability Lab at Yale University in New Haven, Conn., and shared with Becker’s. The closure data is tracked through June 1, 2026. Hospital beds per 1,000 residents fell more than 20% over the period, from nearly three to just over two, and declined in every state.

The findings come from the Closures and Openings Explorer, a free interactive tool that tracks U.S. hospital changes from 2000 through June 2026 at the national, state, county and commuting-zone level. The dataset covers general, short-term, acute-care hospitals and excludes specialty facilities such as psychiatric, rehabilitation, children’s and VA hospitals. Researchers verified hospitals against state filings, financial statements, hospital websites and news reports, according to the release.

Hospital openings from 2024 forward were not tracked systematically and may be undercounted. The year 2000 served as the baseline, so hospitals already operating that year are not counted as openings. The state-by-state net-change figures below cover 2001 to 2023, the period for which both openings and closures are fully tracked, as well as total closures by state through June 2026.

“When we began this research, I expected to see more hospitals closing than opening. That’s true, but for every 10 hospitals that closed, eight opened. That surprised me,” Zack Cooper, PhD, director of the Health Care Affordability Lab at Yale, said in the release.

Here is the total number of hospital closures, by state, through June 2026, according to data from the tool shared with Becker’s:

States with the most hospital closures (2000 through June 2026):

  1. Texas: 98
  2. California: 64
  3. Pennsylvania: 54
  4. New York: 45
  5. Ohio: 31
  6. Tennessee: 26
  7. Georgia: 26
  8. Louisiana: 25
  9. Missouri: 25
  10. Alabama: 24

For the period in which both openings and closures are fully tracked, 2001 to 2023, 644 hospitals closed and 502 opened, for a net loss of 142. Twenty-nine states saw more closures than openings. Sixteen gained more hospitals than they lost. Five saw no net change. Here is how each state fared on net change, according to data shared with Becker’s

States with the greatest net losses of hospitals (2001 to 2023):

  1. California: 62 closures, 21 openings, net -41
  2. New York: 41 closures, 2 openings, net -39
  3. Pennsylvania: 46 closures, 18 openings, net -28
  4. Georgia: 25 closures, 8 openings, net -17
  5. Michigan: 22 closures, 5 openings, net -17
  6. New Jersey: 16 closures, 1 opening, net -15
  7. Tennessee: 23 closures, 9 openings, net -14
  8. Illinois: 18 closures, 5 openings, net -13
  9. Missouri: 20 closures, 7 openings, net -13
  10. Alabama: 17 closures, 6 openings, net -11

States with the greatest net gains of hospitals (2001 to 2023):

  1. Texas: 131 openings, 91 closures, net +40
  2. Colorado: 17 openings, 2 closures, net +15
  3. Arizona: 23 openings, 11 closures, net +12
  4. Florida: 32 openings, 21 closures, net +11
  5. Nevada: 13 openings, 2 closures, net +11
  6. Wisconsin: 15 openings, 5 closures, net +10
  7. Utah: 8 openings, 0 closures, net +8
  8. New Mexico: 8 openings, 3 closures, net +5
  9. Washington: 9 openings, 4 closures, net +5
  10. Wyoming: 5 openings, 0 closures, net +5

States with no net change (2001-2023): Connecticut, Idaho, Nebraska, New Hampshire, Vermont. 

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