Rural Hospital Closures: 2023 Update

Link	View Research Recap
Date	06/2023
Description	From 2005 through 2022, 186 rural hospitals either closed completely or converted to facilities that no longer provide in-patient care. This Recap explores the current state of rural hospital closures in the United States.
Topics	Critical Access Hospitals (CAHs), Healthcare access, Hospitals and clinics

Rural Health Research Products Included in this Recap

• Association Between Rural Hospital Service Changes and Community Demographics
  Policy Brief
  North Carolina Rural Health Research and Policy Analysis Center
  Date: 05/2022
  Research has shown that among rural communities, those with a larger percentage of Black or Hispanic residents were more likely to experience a local hospital closure. This brief explores possible associations between the proportion of a rural community belonging to a AHRQ-identified priority population and local hospital service changes.
• Changes in the Provision of Health Care Services by Rural Critical Access Hospitals and Prospective Payment System Hospitals in 2009 Compared to 2017
  Policy Brief
  North Carolina Rural Health Research and Policy Analysis Center
  Date: 08/2022
  The purpose of this brief is to explore changes in the availability and provision of different health care services among rural CAHs and PPS hospitals in 2009 compared to 2017.
• Rural Hospitals That Closed Between 2017‐20: Profitability and Liquidity in the Year Before Closure
  Policy Brief
  North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
  Date: 01/2022
  This brief examines the preclosure profitability and liquidity performance of rural hospitals that closed between 2017‐20 and compare it to the median performance of rural hospitals that remained open during the same year.
• Since 1990, Rural Hospital Closures Have Increasingly Occurred in Counties That Are More Urbanized, Diverse, and Economically Unequal
  Policy Brief
  North Carolina Rural Health Research and Policy Analysis Center
  Date: 03/2022
  The brief describes the socio‐economic, demographic, and health system characteristics for rural counties with and without hospital closures between 1990 and 2020. We analyzed potential differences among counties that experienced rural hospital closures from 2010‐2020 compared to counties with rural hospital closures from 1990‐2009.
• Trends in Revenue Sources Among Rural Hospitals
  Policy Brief
  North Carolina Rural Health Research and Policy Analysis Center
  Date: 05/2022
  Possible issues with existing rural hospital financing models suggest that outpatient-centric payment methods may be more effective in providing financial relief to rural hospitals. Given this, we explored the financial importance of outpatient care to rural hospitals by estimating changes in outpatient care as a source of revenue.
• Types of Rural and Urban Hospitals and Counties Where They Are Located
  Policy Brief
  North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
  Date: 07/2022
  The purpose of this brief is to provide a snapshot of the types of rural and urban hospitals and the counties where they are located.