Longstanding financial and logistical challenges seem to be intensifying for rural-area providers, as evidenced by new data from consulting firm Chartis, which highlights that 46% of rural hospitals currently have negative operating margins and many of those are in danger of closing. In the past year, 18 rural hospitals closed or transitioned to provide only outpatient care. Of the 48 states that are home to rural hospitals, 38 have at least one hospital that is vulnerable to potential closure—a list led by Texas, Kansas, Mississippi, Oklahoma, and Georgia. The loss of access to care is part of a broader trend that has now seen a total of 182 rural hospital closures since 2010. About 46 million Americans live in a rural area, and they tend to carry a higher disease burden than other locales, further straining capacity for rural providers. In terms of payer mix within rural communities, Medicare Advantage enrollment is increasing, which can create added administrative burdens for providers compounded by a payment model that generally results in lower net reimbursement, the whitepaper notes.
Going for growth: Rural areas are the fastest growing geographic markets for urgent care (UC) right now, largely driven by the closures of hospitals in the last 15 years. Rural and rural-adjacent areas collectively comprised 32% of all UC centers in June 2024 and accounted for 26% of new rooftops, according to National Urgent Care Realty. In fact, rural areas added UC rooftops 40% faster than suburban areas, although a slowdown is expected in 2025. Read more about the booming growth of UC in rural areas from the JUCM archive: Rural Urgent Care Growth Continues, But Challenges Remain.