In 2023, roughly ** percent of community hospitals across the United States were rural hospitals. The number of hospital closures have outweighed openings, leading to an overall decrease in the number of community hospitals in the U.S. in the past years. Rural hospitals are disproportionally affected. Over **** of the decline in the number of community hospitals to date were rural hospitals.

As of April 2025, there were a total of ***** critical access hospitals in the United States. Most of these were found in Texas, followed by Kansas, Iowa, and Minnesota. The Centers for Medicare and Medicaid services (CMS) gives eligible rural hospitals the designation critical access hospital (CAH) to reduce their financial vulnerability and improve access to healthcare.

Between 2005 and May 2025, a total of *** rural hospitals have completely closed or been converted*, no longer providing in-patient services in the United States. The number of closures has fluctuated, with more hospitals having completely closed than converted.

As of June 2025, some *** rural hospitals in the United States were at immediate risk of closure. These hospitals were mostly concentrated in the following states: *************************, and *****. Already, *** rural hospitals have closed or converted since 2005, with most of these happening in 2019 and 2020.

Hospitals play a critical role in healthcare, offering specialized treatments and emergency services essential for public health, regardless of economic fluctuations or individuals' financial situations. Rising incomes and broader access to insurance have fueled demand for care in recent years, supporting hospitals' post-pandemic recovery initiated by federal policies and funding. The recovery for many hospitals was also promoted by mergers that lessened financial strains, especially in rural hospitals. This trend toward consolidation has resulted in fewer enterprises relative to establishments, enhancing hospitals' bargaining power regarding input costs and insurance reimbursements. With this improved position, hospitals are expected to see revenue climb at a CAGR of 2.0%, reaching $1.5 trillion by 2025, with a 3.2% increase in 2025 alone. Competition, economic conditions and regulatory changes will impact hospitals based on size and location. Smaller hospitals, particularly rural ones, may encounter more significant obstacles as the industry transitions from fee-based to value-based care. Independent hospitals face wage inflation, staffing shortages and drug supply costs. Although state and federal policies aim to support small rural hospitals in addressing hospital deserts, uncertainties linger over federal Medicare funding and Medicaid reimbursements, which account for nearly half of hospital care spending. Even so, increasing per capita disposable income and increasing the number of individuals with private insurance will boost revenues from private insurers and out-of-pocket payments for all hospitals, big and small. Hospitals will continue incorporating technological advancements in AI, telemedicine and wearables to enhance their services and reduce cost. These technologies aid hospital systems in strategically expanding outpatient services, mitigating the increasing competitive pressures from Ambulatory Surgery Centers (ASCs) and capitalizing on the increased needs of an aging adult population and shifts in healthcare delivery preferences. As the consolidation trend advances and technology adoption further leverages economies of scale, industry revenue is expected to strengthen at a CAGR of 2.4%, reaching $1.7 trillion by 2030, with steady profit over the period.

As of 2025, over half of U.S. rural hospitals did not offer labor and delivery services. In ** states in the country, over two-thirds of rural hospitals did not offer maternity care services. A lack of obstetric services in rural hospitals was most prolific in states such as Florida and North Dakota, with ** percent, and ** percent of hospitals respectively.

Note - this is not real-time status information, the data represents bed utilization based on annual estimates of how many beds are used versus available.Definitive Healthcare is the leading provider of data, intelligence, and analytics on healthcare organizations and practitioners. In this service, Definitive Healthcare provides intelligence on the numbers of licensed beds, staffed beds, ICU beds, and the bed utilization rate for the hospitals in the United States. Please see the following for more details about each metric, data was last updated on 17 March 2020:

Number of Licensed beds: is the maximum number of beds for which a hospital holds a license to operate; however, many hospitals do not operate all the beds for which they are licensed. This number is obtained through DHC Primary Research. Licensed beds for Health Systems are equal to the total number of licensed beds of individual Hospitals within a given Health System.

Number of Staffed Bed: is defined as an "adult bed, pediatric bed, birthing room, or newborn ICU bed (excluding newborn bassinets) maintained in a patient care area for lodging patients in acute, long term, or domiciliary areas of the hospital." Beds in labor room, birthing room, post-anesthesia, postoperative recovery rooms, outpatient areas, emergency rooms, ancillary departments, nurses and other staff residences, and other such areas which are regularly maintained and utilized for only a portion of the stay of patients (primarily for special procedures or not for inpatient lodging) are not termed a bed for these purposes. Definitive Healthcare sources Staffed Bed data from the Medicare Cost Report or Proprietary Research as needed. As with all Medicare Cost Report metrics, this number is self-reported by providers. Staffed beds for Health Systems are equal to the total number of staffed beds of individual Hospitals within a given Health System. Total number of staffed beds in the US should exclude Hospital Systems to avoid double counting. ICU beds are likely to follow the same logic as a subset of Staffed beds.

Number of ICU Beds - ICU (Intensive Care Unit) Beds: are qualified based on definitions by CMS, Section 2202.7, 22-8.2. These beds include ICU beds, burn ICU beds, surgical ICU beds, premature ICU beds, neonatal ICU beds, pediatric ICU beds, psychiatric ICU beds, trauma ICU beds, and Detox ICU beds.

Bed Utilization Rate: is calculated based on metrics from the Medicare Cost Report: Bed Utilization Rate = Total Patient Days (excluding nursery days)/Bed Days Available

Potential Increase in Bed Capacity: This metric is computed by subtracting “Number of Staffed Beds from Number of Licensed beds” (Licensed Beds – Staffed Beds). This would provide insights into scenario planning for when staff can be shifted around to increase available bed capacity as needed.

Hospital Definition: Definitive Healthcare defines a hospital as a healthcare institution providing inpatient, therapeutic, or rehabilitation services under the supervision of physicians. In order for a facility to be considered a hospital it must provide inpatient care.

Hospital types are defined by the last four digits of the hospital’s Medicare Provider Number. If the hospital does not have a Medicare Provider Number, Definitive Healthcare determines the Hospital type by proprietary research.

Hospital Types:

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Short Term Acute Care Hospital (STAC)

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Provides inpatient care and other services for surgery, acute medical conditions, or injuries

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Patients care can be provided overnight, and average length of stay is less than 25 days

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Critical Access Hospital (CAH)

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25 or fewer acute care inpatient beds

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Located more than 35 miles from another hospital

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Annual average length of stay is 96 hours or less for acute care patients

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Must provide 24/7 emergency care services

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Designation by CMS to reduce financial vulnerability of rural hospitals and improve access to healthcare

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Religious Non-Medical Health Care Institutions

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Provide nonmedical health care items and services to people who need hospital or skilled nursing facility care, but for whom that care would be inconsistent with their religious beliefs

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Long Term Acute Care Hospitals

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Average length of stay is more than 25 days

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Patients are receiving acute care - services often include respiratory therapy, head trauma treatment, and pain management

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Rehabilitation Hospitals

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Specializes in improving or restoring patients' functional abilities through therapies

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Children’s Hospitals

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Majority of inpatients under 18 years old

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Psychiatric Hospitals

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Provides inpatient services for diagnosis and treatment of mental illness 24/7

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Under the supervision of a physician

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Veteran's Affairs (VA) Hospital

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Responsible for the care of war veterans and other retired military personnel

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Administered by the U.S. VA, and funded by the federal government

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Department of Defense (DoD) Hospital

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Provides care for military service people (Army, Navy, Air Force, Marines, and Coast Guard), their dependents, and retirees (not all military service retirees are eligible for VA services)

The Rural Health Clinic (RHC) Enrollments dataset provides enrollment information on all RHCs currently enrolled in Medicare. This data includes information on the RHC's legal business name, doing business as name, organization type and address.

Air ambulance providers have experienced growing demand because of an aging population, hospital and healthcare provider consolidation and deteriorating access to adequate healthcare in rural areas. As people age, they are more likely to require emergency medical transport services, including air ambulance service. The increase in the number of adults aged 65 and older has significantly contributed to demand growth. Consolidation among healthcare providers and the closure of rural hospitals have reduced the number of specialty care and emergency department facilities, making patient transfers between facilities more common, with industry revenue forecast to strengthen at a CAGR of 3.8% to $3.3 billion through 2024, including growth of 2.3% in 2024 alone. Technological innovations such as advanced GPS, real-time data transmission and modern air ambulances equipped with advanced life-support systems, telemedicine capabilities and portable diagnostic devices have transformed the scope of services. These advancements enhance efficiency and response times, boosting reliability and demand for air ambulance services over longer distances. However, the industry faces high fixed costs and an oversaturated market. Increased competition has decreased the number of patients per aircraft, driving up per-ride costs. In emergency scenarios involving uninsured patients, decisions for air transport are based on medical necessity and payment often initially falls on the patient, despite the availability of financial assistance and cost-reduction options. Prohibiting balance billing for out-of-network services may require insurance companies to pay a fair rate, reducing unexpected financial burdens on patients. Looking ahead, innovations such as autonomous drones and enhanced telemedicine will improve efficiency, reduce costs, reliability and patient outcomes and increase demand in rural and less accessible areas. However, advancements in ground ambulance services, telehealth solutions and mobile medical units pose competition, potentially tempering the demand for air ambulances, particularly in urban settings with better local emergency care. Despite these challenges, the aging population will continue driving demand. As more patients are diagnosed with emergency air transport conditions, the need for air ambulances will grow. Through 2029, industry revenue is forecast to increase at a CAGR of 2.7% to $3.7 billion, with profit stagnating.

Report to the Appropriations Committee of the United States House of Representatives in Response to Conference Committee Report to PL 110-186. In an effort to provide a snapshot of the quality of care provided at VA health care facilities, this report includes information about waiting times, staffing level, infection rates, surgical volumes, quality measures, patient satisfaction, service availability and complexity, accreditation status, and patient safety. The data in this report have been drawn from multiple sources across VHA. This dataset defines the quality of care at a national level between rural vs urban populations.

BackgroundDischarge against medical advice (DAMA) and inpatient admission (IA) among emergency department (ED) visits are two important outcomes in hospital utilization, while the first one has been mainly considered a negative outcome.AimsThis study aimed to examine the association of socioeconomic factors with DAMA and IA among ED visits with substance use (age 12–64 years) before and after the COVID-19 pandemic.MethodsThe study retrospectively analyzed the Nationwide Emergency Department Sample (NEDS) from 2019 to 2020. The International Classification of Diseases 10th Revision (ICD-10) codes were used to identify opioid, cannabis, and alcohol use, and smoking.ResultsThe pandemic was significantly associated with higher odds of IA (OR 1.04, CI 1.02–1.06). Female gender and rural hospitals were adversely associated with both DAMA and IA, but lower household incomes were positively and negatively associated with DAMA and IA, respectively. Race and health insurance were partly differently associated with these outcomes. Asian patients exhibited significantly lower odds (OR 0.82, CI 0.71–0.88) regarding DAMA. Black (OR 0.79, CI 0.78–0.80) and Native American patients (OR 0.87, CI 0.82–0.90) exhibited lower odds, and Hispanic (OR 1.05, CI 1.03–1.06) and Asian patients (OR 1.40, CI 1.33–1.44) had higher odds compared to White patients in terms of AI. Except for self-pay, which was associated with lower odds of IA, Medicaid, self-pay, and free care were significantly associated with higher odds of DAMA and IA. Our results also showed that the COVID-19 pandemic affected the association of health insurance with IA, but not with DAMA.ConclusionThese findings highlight the complex association of socioeconomic factors with DAMA and IA. By addressing these differences within the hospital setting, providers can mitigate the negative consequences of substance use on patient health and reduce the burden on healthcare systems.

The U.S. Telemedicine Market size was valued at USD 38.04 USD Billion in 2023 and is projected to reach USD 101.80 USD Billion by 2032, exhibiting a CAGR of 15.1 % during the forecast period. The process of providing medical care to patients through telecommunication is called telemedicine. Its three major forms are real-time interaction through video conferencing, store-and-forward where medical data is exchanged asynchronously, and remote patient monitoring using wearable devices. A feature set contains aspects of accessibility, convenience, and cost-effectiveness. It spreads to general practice, psychiatric services, as well as chronic disease management. The US market today shows a dramatic increase caused by technological progress, growing patients' and providers' acceptance, and expanded reimbursement policies by insurers. Recent developments include: July 2023 – Philips and CoxHealth collaborated for the co-development of an in-house virtual care solution., April 2022 – Andor Health and Medical University of South Carolina (MUSC Health) partnered for the implementation of an AI tool to improve virtual health services., October 2021 – Mercer joined IMPACT’s virtual first care collaboration to identify risks and address gaps in virtual healthcare.. Key drivers for this market are: Increasing Sports and Musculoskeletal Injuries to Boost Market Growth Prospects. Potential restraints include: Technological Barriers in Rural Areas to Hinder Market Growth. Notable trends are: Increasing Number of Hospitals and ASCs Identified as Significant Market Trend.

In 2023, Medicare Advantage (MA) reimbursed rural hospitals at **** percent of Traditional Medicare rates in the United States. In all five reported years, MA rates were lower than traditional Medicare rates, which were already less than the cost of care.

The PA_Rural_Health_Clinics_2016 layer contains the latitude and longitude coordinates of 72 rural health clinics in Pennsylvania. When possible, efforts were made to confirm the rooftop location of each rural health clinic. The accuracy of geocoding is available in Geocoding Certainty attribute field (Geocoding Certainty: Rooftop="00", Street="01", Zip Centroid="04", Not geocoded="99"). Latitude and longitude fields are recorded in the WGS 1984 coordinate system.Last updated: 11/09/2016Contact Us: Pennsylvania Department of HealthDivision of Health InformaticsRA-DHICONTACTUS@pa.gov717-782-2448

© Division of Health Informatics This layer is a component of DepHealth.

Number and percent of HRSA RWHAP providers in rural areas, 2017.

Abstract

Nigeria has one of the largest stocks of human resources for health (HRH) in Africa. However, great disparities in health status and access to health care exist among the six geo-political zones, and between rural and urban areas. This assessment measures the size, skills mix, distribution, and growth rate of HRH in the public health sector in Nigeria. The assessment also quantifies the increase in HRH requirements in the public health sector necessary for reaching key PEPFAR targets and the health Millennium Development Goals. The findings are based on a survey conducted in April-May 2006 in 290 public health facilities representing all levels of care (primary, secondary, and tertiary). The study data enabled us to estimate the total number of doctors, nurses, midwives, lab and pharmacy staff, and community health workers currently employed in the public sector. The distribution of health workers by level of care, and HRH availability in rural and urban areas was also quantified.Staff attrition rates, measuring the number of those leaving the public sector as percent of total staff, were determined among all staff categories. The annual growth in HRH in the public sector from new graduates was also measured.

Geographic coverage

National

Analysis unit

Public Health Facilities

Universe

The survey focused on public health facilities representing all levels of care (primary, secondary, and tertiary).

Kind of data

Sample survey data [ssd]

Sampling procedure

Two-Stage Stratified Random Sample A survey was conducted in 290 public health facilities representing all levels of care (primary, secondary, and tertiary). The facilities were selected using two-stage stratified sampling. First, two states were selected from each of the six geo-political zones in Nigeria, with probability of selection of each state proportional to its population size. In addition, the Federal Capital Territory of Abuja (FCT) was added to the two states selected in the North Central zone. The selected states in each zone cover between 32 and 50 percent of the zone's population and in total, the 13 states included in the sample account for 40 percent of Nigeria's population. In the second stage of sampling, a sample of facilities at each level of care was chosen in each selected state. All Federal Medical Centers and teaching hospitals in the sampled states were selected with certainty. All other facilities were selected using systematic random sampling. A higher proportion of hospitals, compared to smaller facilities, were included in the sample in order to increase the number of facilities that have most of the data being collected. Primary care facilities include health centers, health clinics, maternities, and dispensaries. There was non-response from two facilities selected with certainty.

Mode of data collection

Face-to-face [f2f]

Research instrument

Data collection instrument In each of the selected facilities, a questionnaire was administered to eligible facility managers and health staff. These were staff in charge of the services included in the survey – for example, information regarding immunizations in a hospital was obtained from the nurse in charge at the hospital’s child health clinic. The questionnaire collected information on: 1. Number of staff employed in 2004, 2005, and at the time of survey (April 2006); 2. Number of incoming and outgoing staff in 2005 by reason for leaving or starting work at the facility; 3. Types of services provided at the facility for HIV/AIDS, TB, malaria, maternal and child health, and family planning; 4. Number of patients seen at the facility in the three months preceding the survey for each of these services; 5. Which types of health staff provide each service; 6. Average time spent per patient-visit for each of the services related to the five focus areas.

Cleaning operations

Data from the survey questionnaires was entered electronically using an EpiInfo database, and all data analysis was performed using Stata v.8 software.

Factors associated with availability of telehealth care in hospitals providing oncology services in 2019.