Most rural hospital closures from 2010 to 2021 happened in states that didn't expand Medicaid

Low reimbursement, staffing shortages, low patient volumes and regulatory barriers were among the causes of 136 rural hospitals closing between 2010 and 2021, according to a Sept. 8 report by the American Hospital Association. 

Of those closures, 73 were full closures and 63 were converted closures. 

"While many hospitals and health systems are facing unprecedented challenges, those faced in rural America are unique," AHA president and CEO Rick Pollack said in a statement. "We must ensure that hospitals have the support and flexibility they need to continue to be providers of critical services and access points for patients and communities."

Six findings: 

1. Seventy-four percent of rural closures between 2010 and 2021 occurred in states where Medicaid expansion was not in place or had been so for less than a year. 

2. Nineteen rural hospitals closed in 2020 — the most of any year in the past decade. 

3. Ten percent of U.S. physicians practice in rural areas dispute those areas accounting for 14 percent of the country's population. 

4. Hospitals accounted for one in every 12 rural jobs in 2020. 

5. About half of the hospitals that closed between 2010 and 2020 were independent. 

6. AHA said rural hospitals require increased attention from state and federal governments to address barriers and invest in new resources. It called on Congress to extend the Medicare-dependent Hospital program and the Low-Volume Hospital program, which are set to expire Oct. 1. 

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