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- 'Spreading like Wildfire': How One KY County Is Grappling with a National Tick-Borne Scourge
- HRSA Awards Nearly $90 Million to Expand Addiction Treatment and Recovery Services in Rural Communities
- FORHP Awards More Than $6 Million to Strengthen Rural Health Networks
- HRSA Awards Nearly $19 Million to Expand Access to Healthcare Through Telehealth and Innovative Technologies
698 Rural Hospitals at Risk of Closing, By State
From Becker’s Hospital Review
Nearly 700 rural hospitals across the country, about one-third of all rural facilities in the U.S., are at risk of closing due to severe financial problems, according to an Oct. 28 Center for Healthcare Quality and Payment Reform analysis.
Of the 698 hospitals at risk, 260 face immediate risk of closure. Rural hospitals are at risk of closing in almost every state, except four: Utah, Delaware, Maryland and New Jersey. More than 25% of rural hospitals are at risk of closure in the majority of states and 50% or more are at risk in 11 states.
The numbers are slightly lower than the July CHQPR analysis, which found 700 hospitals at risk of closure and 264 at risk of immediate closure. They are also down from the think tank’s May report, in which 720 hospitals were at risk of closure with 294 at immediate risk.
Becker’s has reported on just six planned hospital and emergency department closures so far in 2026. At this point in 2025, Becker’s had already reported on 22.
Since 2015, 110 hospitals have closed, the report found. Since 2023, 56 hospitals have ended inpatient services to qualify for grants that are available only to rural emergency hospitals. That number was 53 in July 2026.
More than 40% of rural hospitals are still losing money on delivering patient services, and more than a quarter of rural hospitals lost money overall in 2025. In July, the analysis reported nearly one-third of rural hospitals had lost money in 2024 and 2025.
The center’s report said private insurers are the primary reason rural hospitals are at risk of losing money. About half of the services at an average rural hospital go to patients with private insurance, including employer-sponsored plans and Medicare Advantage. Losses on these patients, not Medicare or Medicaid payments, determines in many cases whether a rural hospital loses money.
Increased payments enough to prevent closures of at-risk hospitals would cost about $4 billion per year, the analysis said. The July report estimated $5 billion.
“Rural hospitals should not be forced to eliminate inpatient care in order to receive higher payments for other services, as is required under the federal ‘Rural Emergency Hospital’ program,” the analysis said. “Federal programs should preserve and expand rural healthcare services, not reduce them.”
The state-by-state breakdown below shows rural hospitals at risk of closing and those at immediate risk, with the percentage of rural hospitals that number represents:
Alabama
24 hospitals at risk of closing (52%)
17 at immediate risk of closing (37%)
Alaska
2 hospitals at risk of closing (12%)
1 at immediate risk of closing (6%)
Arizona
4 hospitals at risk of closing (15%)
0 at immediate risk of closing (0%)
Arkansas
32 hospitals at risk of closing (70%)
8 at immediate risk of closing (17%)
California
16 hospitals at risk of closing (27%)
4 at immediate risk of closing (7%)
Colorado
11 hospitals at risk of closing (26%)
3 at immediate risk of closing (7%)
Connecticut
3 hospitals at risk of closing (75%)
2 at immediate risk of closing (50%)
Delaware
0 hospitals at risk of closing (0%)
0 at immediate risk of closing (0%)
Florida
9 hospitals at risk of closing (41%)
3 at immediate risk of closing (14%)
Georgia
22 hospitals at risk of closing (30%)
9 at immediate risk of closing (12%)
Hawaii
8 hospitals at risk of closing (62%)
0 at immediate risk of closing (0%)
Idaho
8 hospitals at risk of closing (30%)
2 at immediate risk of closing (7%)
Illinois
15 hospitals at risk of closing (19%)
8 at immediate risk of closing (10%)
Indiana
10 hospitals at risk of closing (18%)
5 at immediate risk of closing (9%)
Iowa
8 hospitals at risk of closing (9%)
2 at immediate risk of closing (2%)
Kansas
58 hospitals at risk of closing (58%)
21 at immediate risk of closing (21%)
Kentucky
13 hospitals at risk of closing (19%)
2 at immediate risk of closing (3%)
Louisiana
24 hospitals at risk of closing (43%)
10 at immediate risk of closing (18%)
Maine
10 hospitals at risk of closing (42%)
2 at immediate risk of closing (8%)
Maryland
0 hospitals at risk of closing (0%)
0 at immediate risk of closing (0%)
Massachusetts
1 hospital at risk of closing (14%)
0 at immediate risk of closing (0%)
Michigan
10 hospitals at risk of closing (15%)
3 at immediate risk of closing (5%)
Minnesota
15 hospitals at risk of closing (15%)
3 at immediate risk of closing (3%)
Mississippi
35 hospitals at risk of closing (52%)
24 at immediate risk of closing (36%)
Missouri
29 hospitals at risk of closing (51%)
10 at immediate risk of closing (18%)
Montana
15 hospitals at risk of closing (29%)
3 at immediate risk of closing (6%)
Nebraska
5 hospitals at risk of closing (7%)
0 at immediate risk of closing (0%)
Nevada
4 hospitals at risk of closing (31%)
1 at immediate risk of closing (8%)
New Hampshire
5 hospitals at risk of closing (28%)
1 at immediate risk of closing (6%)
New Jersey
0 hospitals at risk of closing (0%)
0 at immediate risk of closing (0%)
New Mexico
7 hospitals at risk of closing (26%)
1 at immediate risk of closing (4%)
New York
22 hospitals at risk of closing (43%)
10 at immediate risk of closing (20%)
North Carolina
9 hospitals at risk of closing (16%)
5 at immediate risk of closing (9%)
North Dakota
13 hospitals at risk of closing (35%)
3 at immediate risk of closing (8%)
Ohio
6 hospitals at risk of closing (8%)
3 at immediate risk of closing (4%)
Oklahoma
44 hospitals at risk of closing (61%)
17 at immediate risk of closing (24%)
Oregon
7 hospitals at risk of closing (21%)
3 at immediate risk of closing (9%)
Pennsylvania
18 hospitals at risk of closing (35%)
9 at immediate risk of closing (17%)
Rhode Island
1 hospital at risk of closing (100%)
0 at immediate risk of closing (0%)
South Carolina
7 hospitals at risk of closing (32%)
2 at immediate risk of closing (9%)
South Dakota
5 hospitals at risk of closing (10%)
3 at immediate risk of closing (6%)
Tennessee
19 hospitals at risk of closing (36%)
12 at immediate risk of closing (23%)
Texas
84 hospitals at risk of closing (55%)
26 at immediate risk of closing (17%)
Utah
0 hospitals at risk of closing (0%)
0 at immediate risk of closing (0%)
Vermont
8 hospitals at risk of closing (62%)
0 at immediate risk of closing (0%)
Virginia
6 hospitals at risk of closing (18%)
3 at immediate risk of closing (9%)
Washington
19 hospitals at risk of closing (43%)
6 at immediate risk of closing (14%)
West Virginia
8 hospitals at risk of closing (24%)
4 at immediate risk of closing (12%)
Wisconsin
13 hospitals at risk of closing (16%)
6 at immediate risk of closing (7%)
Wyoming
6 hospitals at risk of closing (22%)
3 at immediate risk of closing (11%)
Pennsylvania Medicaid Launches Work Requirements (MAWR) Screen Changes
The Department of Human Services released new documents showing the COMPASS Medical Assistance Work Requirement (MAWR) screen changes for the application, renewal, and presumptive eligibility workflows.
These changes will apply to the Medicaid Expansion (MG90/91) population. Beneficiaries designated as Head of Household and who are subject to the MAWR will see their work requirements status on My Benefits screen in their myCOMPASS account on the COMPASS website and myCOMPASS mobile app.
- There are only two categories, satisfied or pending
- Individuals in compliance with work requirements or who are exempt will show “Satisfied.”
- Once a non-compliance notice is sent, the status will show as “Pending.”
- My Benefits screen is only available to currently enrolled individuals, not new applicants.
NHSC Students to Service Loan Repayment Program Now Open
The National Health Service Corps is now accepting applications for the Students to Service Loan Repayment program through November 19 at 7:30 pm. Eligible students in their last year of medical, physician assistant, nursing, or dental school can apply for up to $120,000 in loan repayment funding in exchange for 3 years of full-time service in urban, rural, or frontier communities with limited access to care.
Learn more and apply before the deadline.
Guidance for Measles in Pregnancy and Congenital Measles Health Advisory Published
In response to ongoing measles outbreaks and the first reported cases of congenital measles in decades, the Pennsylvania Department of Health (DOH) released an official advisory for the prevention and management of measles during pregnancy and in newborns. The advisory emphasizes that MMR vaccination before pregnancy remains the best protection.
For more information, review the advisory.
HHS Launches Newborn Essentials Support Toolkit Program to Support Mothers and Babies
The U.S. Department of Health and Human Services (HHS) launched the Newborn Essentials Support Toolkit (NEST) Program at West Virginia University Medicine Golisano Children’s Hospital in Morgantown, West Virginia, marking the next phase of a federal initiative designed to support mothers and babies during the critical first days and weeks after birth.
NEST provides families with a one-time kit of essential newborn and postpartum supplies, maternal health items, and trusted information and resources around the time of birth. For more information, visit hhs.gov/newbaby.
Hospitals File Lawsuit Against HRSA to Block the 340B Rebate Model
The American Hospital Association, Maine Hospital Association, and four safety-net hospitals filed a lawsuit against HRSA to block the 340B rebate model.
- The lawsuit argues that HHS and HRSA illegally ignored feedback on the substantial financial and administrative burden the rebate model will have on [covered entities] and suggestions for alternative approaches.
- In this new lawsuit, the hospital industry is returning to same legal playbook that successfully blocked the initial rebate model in December 2025, with the same plaintiffs filing in the same District Court.
They also filed a motion for a temporary restraining order asking the court to halt the pilot before it begins on January 1, 2027.
Pennsylvania House Adopts Resolution to Study Primary Care Workforce
The Pennsylvania House of Representatives recently adopted House Resolution 534, sponsored by Rep. Arvind Venkat, MD. This resolution directs the Joint State Government Commission to conduct a study on why medical students do or do not choose primary care careers and what can be done to increase Pennsylvania’s primary care workforce.
The Commission will evaluate how effectively medical schools promote primary care careers, the extent of primary care training in medical school curricula, and other factors influencing students’ specialty choices. A final report of findings will be submitted to the General Assembly within one year.
AHA Report: Rural Hospitals to See $1.6B Revenue Hit From ACA Subsidy Loss
From Becker’s Hospital Review
Rural hospitals stand to lose $1.6 billion in revenue in 2026 following the expiration of the ACA’s enhanced premium tax credits, according to an Oct. 13 report from the American Hospital Association.
The report, “America’s Rural Hospitals at a Crossroads,” draws the estimate from a Commonwealth Fund analysis that also projects rural hospitals’ uncompensated care costs will rise more than 10% this year.
Congress first passed the enhanced subsidies in 2021, expanding eligibility for and increasing the size of premium tax credits for ACA marketplace coverage. Rural residents were among the biggest beneficiaries because benchmark marketplace premiums run about 10% higher in rural areas, the report said.
With the credits gone, rural states are projected to see a 30% drop in marketplace enrollment and a 36% increase in their uninsured populations from 2026 to 2035, according to a KNG Consulting analysis prepared for the AHA.
More uninsured patients will add to a payer mix that already leans heavily on public coverage. Medicare and Medicaid cover about 72% of rural hospital discharges, and both pay below cost. In 2024, rural hospitals provided more than $5 billion in uncompensated care and absorbed more than $7 billion in Medicare underpayments, a 26% increase from 2020.
“The challenges confronting rural hospitals are both longstanding and intensifying,” the report said.
The subsidy loss compounds Medicaid cuts under HR 1, which could put more than 300 rural hospitals at risk of closure, conversion or service reductions, the report said.
Pennsylvania Raises Alarm on Congenital Measles
From CIDRAP
A new health alert from the Pennsylvania Department of Health is warning doctors about congenital measles, a disease that was once extremely rare in the United States. But now that dozens of pregnant Pennsylvania women have contracted measles in the state’s ongoing outbreak, the potentially fatal infection passed from mother to baby in utero is poised to pose clinical challenges for physicians facing a disease they’ve never seen in practice.
So far, Pennsylvania has said 66 pregnant women have contracted measles while pregnant this year, and at least six babies in the state have been born with measles. Of the six deaths reported in the state, at least two have been in infants, but it’s not known if they had congenital infections.
Releasing information on infant outcomes in those pregnancies is illegal in Pennsylvania. According to NBC News, there is also no national database on congenital measles, likely because the disease hasn’t been routinely seen in the United States for decades.
Pennsylvania Q1 2026 Health Data, Interactive Visualizations, Data Sets Published
The Pennsylvania Health Care Cost Containment Council (PHC4) published its County-Level Utilization Reports, featuring newly released health care data from the first quarter of 2026. This publication is accompanied by two new resources designed to increase transparency and improve access to timely information.
In addition to offering new data for purchase, PHC4’s County-Level Utilization Reports are publicly available and are released quarterly. These reports present the total number of inpatient hospitalizations and ambulatory/outpatient cases for Pennsylvania residents, with data broken down by patient age, sex, and payer type at the county level.
One of the new resources released with the County-Level Utilization Reports is an interactive map designed to improve data transparency through engaging, easy‑to‑understand visualizations. Users can locate their county on the map and quickly access relevant PHC4 data. This tool supports faster, more intuitive exploration of information across Pennsylvania. Additionally, new downloadable Excel data sets allow researchers, policymakers, and local organizations to efficiently manipulate, filter, and analyze population counts for independent tracking and reporting. Together, these features expand the reach and usability of the reports for communities statewide.
PHC4 is an independent council formed under Pennsylvania statute (Act 89 of 1986, as amended by Act 15 of 2020) in order to address rapidly growing health care costs. PHC4 continues to produce comparative information about the most efficient and effective health care to individual consumers and group purchasers of health services. In addition, PHC4 produces information used to identify opportunities to contain costs and improve the quality of care delivered. For more information, visit phc4.org or access the reports here.