Rural Health Information Hub Latest News

57% of Rural Hospitals Lack Maternity Care: 19 States with the Biggest Gaps

From Becker’s Hospital Review

In the past five years, over 100 rural hospitals have stopped delivering babies, contributing to the 57% of rural U.S. hospitals that lack labor and delivery services.

This finding comes from the Center for Healthcare Quality and Payment Reform. Its July report details the number of rural hospitals by state that lack maternity care services, those that do offer such services, the financial losses incurred from maternity care and the travel time to the nearest hospital providing OB services.

“Over 80% of pregnancy-related deaths are preventable with appropriate prenatal, labor & delivery, and post-partum care,” the CHQPR report notes. “Although improvements in maternity care are needed in all parts of the country to reduce mortality rates, one of the greatest challenges is in rural areas, because most rural hospitals are no longer providing maternity care at all.”

Of the 978 rural hospitals that offer labor & delivery services, almost 40% lost money on patient services overall in 2022 through 2023, meaning their ability to continue delivering maternity care is at risk.

Below are the 19 states with the highest percentage of rural hospitals lacking OB or maternity care. In each of these states, the percentage of rural hospitals without OB care exceeds the U.S. average of 57%. There are ties below, resulting in 19 states with 12 rankings for the greatest proportion of hospitals without OB care.

Readers can find CHQPR’s report on maternity care deserts among rural hospitals in full here.

1. Florida 
Total rural hospitals: 22
Number without OB services: 20
Percentage without OB services: 91%

2. North Dakota 
Total rural hospitals: 39
Number without OB services: 31
Percentage without OB services: 79%

3. Louisiana
Total rural hospitals: 56
Number without OB services: 42
Percentage without OB services: 75%

4. Illinois
Total rural hospitals: 74
Number without OB services: 55
Percentage without OB services: 74%

West Virginia
Total rural hospitals: 31
Number without OB services: 23
Percentage without OB services: 74%

5. Nevada
Total rural hospitals: 14
Number without OB services: 10
Percentage without OB services: 71%

6. Virginia
Total rural hospitals: 30
Number without OB services: 21
Percentage without OB services: 70%

7. Alabama
Total rural hospitals: 52
Number without OB services: 36
Percentage without OB services: 69%

Oklahoma
Total rural hospitals: 81
Number without OB services: 56
Percentage without OB services: 69%

8. Mississippi
Total rural hospitals: 72
Number without OB services: 49
Percentage without OB services: 68%

9. Arkansas
Total rural hospitals: 50
Number without OB services: 32
Percentage without OB services: 64%

Georgia
Total rural hospitals: 72
Number without OB services: 46
Percentage without OB services: 64%

Montana
Total rural hospitals: 55
Number without OB services: 35
Percentage without OB services: 64%

10. South Dakota 
Total rural hospitals: 49
Number without OB services: 31
Percentage without OB services: 63%

Pennsylvania
Total rural hospitals: 43
Number without OB services: 27
Percentage without OB services: 63%

11. Iowa
Total rural hospitals: 94
Number without OB services: 58
Percentage without OB services: 62%

12. Texas
Total rural hospitals: 164
Number without OB services: 97
Percentage without OB services: 59%

Kansas
Total rural hospitals: 100
Number without OB services: 59
Percentage without OB services: 59%

California 
Total rural hospitals: 58
Number without OB services: 34
Percentage without OB services: 59%

Rural Graduate Medical Education (GME) Opportunities – How can your RHC get involved?

– Thursday, August 29 at 2:00 pm Eastern. The National Association of Rural Health Clinics (NARHC), in partnership with the Collaborative for Rural Graduate Medical Education Technical Assistance Centers, will host the free, FORHP-supported webinar. Rural Training Track medical students completing rural rotations were more than twice as likely to practice in rural areas than general family medicine graduates. RHCs can play a critical role in that training through their ability to serve as rotational sites for many different providers. This webinar will feature Pennsylvania Rural Health Clinic and Rural Residency Planning and Development grantee, St. Luke’s Miners who will discuss their experience with GME and RHC site

Exploring Housing Challenges and Opportunities for Rural Residency Development

Researchers from the Rural Residency Planning and Development Technical Assistance Center (RuralGME.org), explore challenges, strategic approaches, potential opportunities, and capital funding for rural residency programs to ensure access to safe, secure, affordable, and good-quality housing that is convenient to the workplace. As the number and size rural residency programs continue to grow across the country, housing has not kept pace.

Recruitment of Residents to Rural Programs: Early Outcomes from Cohort 1 of the Rural Residency Planning and Development Grants Program

In this study, published in the Journal of Graduate Medical Education, authors from the Rural Residency Planning and Development Technical Assistance Center (RuralGME.org) explore early resident recruitment outcomes of HRSA’s Rural Residency Planning and Development (RRPD) grants program. The study concluded that the early resident recruitment outcomes represented sufficient success to support the program’s continuation.

MedPac Report on Telehealth Services: Insights and Implications

Recently, the Medicare Payment Advisory Commission (MedPAC) released a report developed by the American Institutes for Research (AIR), which provides an update to a previous 2023 report examining telehealth’s association with healthcare quality, access and cost in Medicare. Key metrics were developed to measure quality, access, and cost in a setting where both telehealth and in-person visits are available for fee-for-service (FFS) Medicare beneficiaries. The health quality outcomes that were examined focused on ambulatory care-sensitive hospitalizations and emergency department visits, while access outcomes focus on clinician encounters. Key findings include the following:

1.           Telehealth and Quality: No significant association was found between telehealth intensity and quality outcomes.

2.           Telehealth and Access: Higher telehealth intensity was associated with fewer clinician encounters for both behavioral and non-behavioral health.

3.           Telehealth and Costs: There was evidence suggesting that higher telehealth intensity is associated with a decrease in the total cost of care, although the results were not conclusively definitive.

Drexel University Kicks Off Inaugural Medical Assistant Apprenticeship Cohort

Sixteen medical assistant apprentices were recently hired by Esperanza Health Center, Jefferson Hospital, and Nemours Children’s Hospital for on-the-job training while taking classes at Drexel University as part of their inaugural Certified Clinical Medical Assistant Apprenticeship Program. This program creates a pathway for those who are underrepresented from the local community to obtain quality careers in health care. Drexel will be recruiting for the next cohort in Spring 2025 and hopes to add additional health care industry partners across the state. If you are interested in connecting with Drexel to explore becoming a clinical site, reach out to Caitlin Wilkinson, Co-Director of the Pennsylvania Primary Care Career Center.

FDA Approves First Nasal Spray for Treatment of Anaphylaxis

The U.S. Food and Drug Administration approved neffy (epinephrine nasal spray) for the emergency treatment of allergic reactions (Type I), including those that are life-threatening (anaphylaxis), in adult and pediatric patients who weigh at least 30 kilograms (about 66 pounds). Neffy is a single dose nasal spray administered into one nostril. As with epinephrine injection products, a second dose (using a new nasal spray to administer neffy in the same nostril) may be given if there is no improvement in symptoms or symptoms worsen. Patients may need to seek emergency medical assistance for close monitoring of the anaphylactic episode and in the event further treatment is required.

Workforce Innovation Act Introduced

Senators Ron Wyden (D-OR), Marsha Blackburn (R-TN), and Ben Ray Luján (D-NM) recently introduced S.4957, the Health Workforce Innovation Act, which would provide federal funding for health center-led workforce development partnerships with high schools and community colleges. A similar bipartisan bill, H.R.7307, was introduced in the House of Representatives earlier this year. We encourage health center advocates, particularly those in Republican districts, to reach out to their senators and representatives to co-sponsor these bills to ensure Congressional support for this legislation remains strongly bipartisan.

Pennsylvania Governor’s Administration Announces $22 Million Investment to Eliminate Student Loan Debt for Substance Use Disorder Workers

Pennsylvania Governor Josh Shapiro and Department of Drug and Alcohol Programs (DDAP) Secretary Dr. Latika Davis-Jones met with recipients of DDAP’s substance use disorder (SUD) student loan repayment program during a roundtable discussion at Dauphin County Drug & Alcohol Services. Through the program, DDAP provides student loan repayment as an incentive to retain SUD practitioners, administrators, and supervisors who commit to continuing to provide services within Pennsylvania. In this latest round of funding, DDAP is awarding $22 million to assist approximately 400 practitioners within the SUD treatment, prevention, case management and recovery support services workforce. The program prioritizes SUD professionals who work in rural areas of the commonwealth that are experiencing SUD workforce shortages as well as those who provide SUD services in counties with underserved minority populations. Click here to learn more.