182 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.
← Back to All ProjectsRural 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.
This includes modeled estimates based on hospital risk scoring and published closure patterns. Here's what changes:
Source notes: closure counts from Chartis 2025; at-risk hospitals from AHA 2025; OB deserts from March of Dimes 2024. Items marked “Est.” are model-based projections or dataset-derived estimates and should be treated as directional.
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.
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.
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.
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.
Health Resources Locator: findahealthcenter.hrsa.gov
Emergency: 911
National Nurse Helpline: 1-800-984-5207
Find federally qualified health centers, rural health clinics, and emergency services in your area.
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