As the COVID-19 outbreak continues to tax hospitals throughout the country, there is a growing concern that many hospitals, in particular rural hospitals, may not have the reserve to remain fiscally viable. A new Health Affairs blog explores the vulnerable state rural providers were in prior to the pandemic, and the capacity for rural providers to deal with a surge of patients. Because most rural hospitals operate on razor thin margins, high margin services such as elective surgery keep them afloat. For many rural hospitals, canceling these profitable services to cope with the outbreak may be the tipping point for financial catastrophe.