⚠️ TIME-SENSITIVE

Healthcare Deserts:
The Coming Crisis

180+ rural hospitals closed since 2010. 432 vulnerable hospitals at immediate risk. Proposed Medicaid cuts could trigger an estimated 200-300 additional closures, leaving millions without emergency care. Interactive county-by-county risk analysis.

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The Death Spiral

Rural hospitals operate on razor-thin margins. Medicaid accounts for 40-60% of their revenue. When reimbursement rates drop, hospitals cut services. Obstetrics goes first. Then surgery. Then specialists leave. Then the ER closes. Then the hospital shuts down entirely. Then the nearest hospital is 30+ miles away. Then people die in ambulances.

Before & After: The Projected Impact

This isn't speculation. We can model exactly what happens if proposed Medicaid cuts pass. Here's what changes:

📊 Current State (2025)

Rural hospitals operating 1,700
Counties with 0 hospitals 77
People >60min from ER Est. 7.2M
Counties without OB care 1,104
Maternal deaths/100k (rural) 28.6

🚨 Projected (If Cuts Pass)

Rural hospitals operating 1,400-1,500
Counties with 0 hospitals 250-300
People >60min from ER Est. 15-20M
Counties without OB care 1,600+
Maternal deaths/100k (rural) Est. 40-50+

Hospital Closure Risk by County

This map shows hospital closure risk scores for U.S. counties, based on poverty rate, uninsured population, rural classification, and hospital infrastructure. Higher risk means hospitals are more likely to close if Medicaid cuts pass.

Low Risk (0-24)
Moderate Risk (25-49)
High Risk (50-74)
Critical Risk (75-100)

Rural Hospital Distribution

Of the 5,380 hospitals in our CMS dataset, 1,370 are classified as Critical Access Hospitals serving rural areas. This chart shows the distribution of hospitals by type and their emergency services capabilities.

Hospital Quality Ratings Distribution

CMS quality ratings range from 1 (lowest) to 5 (highest) stars. Lower-rated hospitals, especially those in rural areas, face higher closure risk. Government-owned hospitals with 2 stars or below are considered high-risk for closure.

State-Level Hospital Risk Analysis

This visualization shows the number of hospitals at risk by state, broken down by risk category. States are sorted by total number of at-risk hospitals, revealing geographic patterns in the rural hospital crisis.

🎬 What You Can Do

This isn't inevitable. These closures can be prevented. But the window is closing. Once hospitals shut down, they don't come back. Here's how to fight this:

Organizations Fighting This: National Rural Health Association • Save Rural Hospitals Coalition • American Hospital Association • State Hospital Associations