Seven hundred and thirty-four rural hospitals across the U.S., which represent one-third of all rural facilities nationwide, are at risk of closing due to severe financial problems, according to the Center for Healthcare Quality and Payment Reform’s most recent analysis.

The hospitals now classified as at risk of closure represent a slight improvement from CHQPR’s previous analysis, when 756 rural facilities faced a closure risk.

More than 100 rural hospitals have also shut their doors over the last decade, leaving millions of Americans without access to emergency rooms and inpatient care in the areas they live. An additional 44 hospitals have ended inpatient services since 2023 to qualify for federal grants exclusively available to rural emergency hospitals, the report said.

The report said inadequate payments from private insurance companies is a primary driver for the hospital closures. Almost half of rural hospitals lose money delivering patient services, with costs per patient running higher in smaller, rural communities versus urban areas due to less residents served relative to fixed service costs.

Three hundred and nine hospitals are at immediate closure risk due to the severity of their financial challenges. In 10 states, 50% or more of rural hospitals are at risk. Facilities with the greatest risk of closure have exhausted financial reserves and carry more debt than assets.

Preventing these closures would cost around $6 billion annually, 0.1% of total national healthcare spending, the report states.

“Most of the higher spending would support primary care and emergency care, since these are the biggest causes of losses at most small rural hospitals,” the report said. “Spending would likely increase as much or more if hospitals close, because reduced access to preventive care and failure to receive prompt treatment will cause rural residents to be sicker and need more services in the future.”

The following state-by-state breakdown shows rural hospitals facing closure risk within six to seven years and those at immediate risk of shutting down in the next two to three years.

Alabama
28 hospitals at risk of closing (58%)
22 at immediate risk of closing in the next two to three years (46%)

Alaska
2 hospitals at risk of closing (12%)
1 at immediate risk of closing in the next two to three years (6%)

Arizona
4 hospitals at risk of closing (15%)
0 at immediate risk of closing in the next two to three years (0%)

Arkansas
31 hospitals at risk of closing (66%)
12 at immediate risk of closing in the next two to three years (26%)

California
16 hospitals at risk of closing (27%)
5 at immediate risk of closing in the next two to three years (8%)

Colorado
10 hospitals at risk of closing (23%)
2 at immediate risk of closing in the next two to three years (5%)

Connecticut
3 hospitals at risk of closing (75%)
2 at immediate risk of closing in the next two to three years (50%)

Delaware
0 hospitals at risk of closing
0 at immediate risk of closing in the next two to three years

Florida
8 hospitals at risk of closing (36%)
3 at immediate risk of closing in the next two to three years (14%)

Georgia
25 hospitals at risk of closing (34%)
11 at immediate risk of closing in the next two to three years (15%)

Hawaii
8 hospitals at risk of closing (62%)
0 at immediate risk of closing in the next two to three years

Idaho
10 hospitals at risk of closing (37%)
1 at immediate risk of closing in the next two to three years (4%)

Illinois
16 hospitals at risk of closing (20%)
8 at immediate risk of closing in the next two to three years (10%)

Indiana
9 hospitals at risk of closing (16%)
8 at immediate risk of closing in the next two to three years (15%)

Iowa
9 hospitals at risk of closing (10%)
2 at immediate risk of closing in the next two to three years (2%)

Kansas
68 hospitals at risk of closing (68%)
30 at immediate risk of closing in the next two to three years (30%)

Kentucky
15 hospitals at risk of closing (22%)
2 at immediate risk of closing in the next two to three years (3%)

Louisiana
25 hospitals at risk of closing (45%)
11 at immediate risk of closing in the next two to three years (20%)

Maine
10 hospitals at risk of closing (42%)
4 at immediate risk of closing in the next two to three years (17%)

Maryland
0 hospitals at risk of closing
0 at immediate risk of closing in the next two to three years

Massachusetts
2 hospitals at risk of closing (29%)
1 at immediate risk of closing in the next two to three years (14%)

Michigan
9 hospitals at risk of closing (14%)
3 at immediate risk of closing in the next two to three years (5%)

Minnesota
19 hospitals at risk of closing (20%)
6 at immediate risk of closing in the next two to three years (6%)

Mississippi
35 hospitals at risk of closing (52%)
24 at immediate risk of closing in the next two to three years (36%)

Missouri
28 hospitals at risk of closing (49%)
10 at immediate risk of closing in the next two to three years (18%)

Montana
16 hospitals at risk of closing (30%)
3 at immediate risk of closing in the next two to three years (6%)

Nebraska
6 hospitals at risk of closing (8%)
3 at immediate risk of closing in the next two to three years (4%)

Nevada
4 hospitals at risk of closing (29%)
1 at immediate risk of closing in the next two to three years (7%)

New Hampshire
4 hospitals at risk of closing (22%)
2 at immediate risk of closing in the next two to three years (11%)

New Jersey
0 hospitals at risk of closing
0 at immediate risk of closing in the next two to three years

New Mexico
8 hospitals at risk of closing (30%)
2 at immediate risk of closing in the next two to three years (7%)

New York
23 hospitals at risk of closing (45%)
15 at immediate risk of closing in the next two to three years (29%)

North Carolina
9 hospitals at risk of closing (16%)
6 at immediate risk of closing in the next two to three years (11%)

North Dakota
14 hospitals at risk of closing (37%)
3 at immediate risk of closing in the next two to three years (8%)

Ohio
7 hospitals at risk of closing (9%)
3 at immediate risk of closing in the next two to three years (4%)

Oklahoma
48 hospitals at risk of closing (65%)
20 at immediate risk of closing in the next two to three years (27%)

Oregon
7 hospitals at risk of closing (21%)
3 at immediate risk of closing in the next two to three years (9%)

Pennsylvania
17 hospitals at risk of closing (33%)
9 at immediate risk of closing in the next two to three years (17%)

Rhode Island
1 hospital at risk of closing (100%)
1 at immediate risk of closing in the next two to three years (100%)

South Carolina
7 hospitals at risk of closing (32%)
4 at immediate risk of closing in the next two to three years (18%)

South Dakota
6 hospitals at risk of closing (12%)
3 at immediate risk of closing in the next two to three years (6%)

Tennessee
17 hospitals at risk of closing (33%)
13 at immediate risk of closing in the next two to three years (25%)

Texas
84 hospitals at risk of closing (55%)
23 at immediate risk of closing in the next two to three years (15%)

Utah
0 hospitals at risk of closing
0 at immediate risk of closing in the next two to three years

Virginia
8 hospitals at risk of closing (26%)
5 at immediate risk of closing in the next two to three years (16%)

Washington
19 hospitals at risk of closing (42%)
7 at immediate risk of closing in the next two to three years (16%)

West Virginia
13 hospitals at risk of closing (38%)
6 at immediate risk of closing in the next two to three years (18%)

Wisconsin
12 hospitals at risk of closing (15%)
5 at immediate risk of closing in the next two to three years (6%)

Wyoming
6 hospitals at risk of closing (22%)
3 at immediate risk of closing in the next two to three years (11%)

The post 734 hospitals at risk of closure, by state appeared first on Becker’s Hospital Review | Healthcare News & Analysis.