The rural hospital closure crisis: 9 things to know

Many rural hospitals across the nation are faced with financial challenges, causing some to close for good.

Here are nine things to know about rural hospital closures:

1. Across the U.S., more than 600 rural hospitals are vulnerable to closure, according to an estimate from iVantage Health Analytics, a firm that compiles a hospital strength index based on data about financial stability, patients and quality indicators.

2. Eighty-nine rural hospitals have closed since 2010, and those closures are spread across 26 states, according to research from the North Carolina Rural Health Research Program.

3. Of the states that have seen at least one rural hospital close since 2010, those with the most closures are in the South.

4. Fifteen hospitals in Texas have closed since 2010, the most of any state. Tennessee has seen the second-most closures, with nine hospitals closing since 2010. In third place is Georgia with seven closures, followed by Alabama, Mississippi, North Carolina and Missouri, which have each seen five hospitals close over the past eight years.

5. Twenty-one of the 67 rural hospitals that closed from 2013 through 2017 were 20 to 35 miles from the closest hospital, according to the Medicare Payment Advisory Commission's June report to Congress.  

6. Although for-profit hospitals accounted for just 11 percent of rural hospitals in 2013, nearly 40 percent of the hospitals that closed between 2013 and 2017 were for-profit, according to a report released in September by the U.S. Government Accountability Office.

7. According to the GAO, rural hospital closures typically occur when hospitals have negative margins and are unable to cover fixed costs.

8. Rural hospitals in Medicaid expansion states were far less likely to close than those in states that had not expanded Medicaid as of April 2018, according to the GAO.

9. Lower incomes and higher rates of uninsured people lead to higher levels of uncompensated care at rural hospitals. This is less of a problem for rural hospitals in states that expanded Medicaid, according to an analysis from the Center on Budget and Policy Priorities, a progressive think tank.

More articles on hospital closures:

2 Tennessee hospitals to close by year's end
Missouri hospital closes: 3 things to know
22 latest hospital bankruptcies, closures

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