State Politics
New Harvard Study Explains Trends in Urban and Rural Hospital Closures
Urban hospitals are closing at roughly the same rate as rural ones, and the shuttered hospitals are more likely to have served communities with high poverty rates and fewer transportation options, according to a new study published Thursday in the journal…
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Key points
- A new Harvard study reveals that urban and rural hospitals are closing at nearly identical rates, with urban closures slightly higher at 9.1% compared to 8.3% for rural areas.
- The United States experienced a net loss of over 24,000 hospital beds between 2010 and 2025, driven by 432 closures and only 216 new openings.
- States that did not expand Medicaid eligibility experienced higher closure rates, particularly affecting vulnerable and low-income counties in the South and Midwest.
NewsWK — Families across the United States face growing healthcare challenges as local medical facilities disappear. A new Harvard hospital closure study reveals that urban and rural hospital closures are happening at surprisingly similar rates.
Why are US hospitals closing in local communities?
According to researchers, small and safety-net facilities in vulnerable counties are the most likely to shut down. These closures leave patients with fewer local beds, forcing families to travel longer distances for emergency care. Between 2010 and 2025, the nation saw a net loss of over 24,000 hospital beds.
The Harvard hospital closure study found an urban closure rate of 9.1%, compared to 8.3% for rural areas. Furthermore, overall closures increased by 4% annually, while new hospital openings decreased by 3% each year.
Specifically, vulnerable facilities often share these three traits:
- Small or safety-net status
- For-profit business models
- Location in counties with high poverty
Where are these medical facilities shutting down?
The Midwest and the South experienced the highest number of shutdowns over the fifteen-year study period. Researchers noted a strong connection between Medicaid expansion and hospital closures. Consequently, states that chose not to expand Medicaid eligibility saw a higher rate of facility shutdowns.
How do hospital closures in the South and Midwest compare?
Rural areas in these regions face unique economic pressures, including fewer doctors per capita and lower patient volumes. While 73% of closed facilities shut down completely, some retained outpatient services. Meanwhile, new hospital construction has favored wealthier urban areas, leaving rural patients with fewer healthcare options.
Healthcare systems are currently preparing for major federal funding shifts. Congress passed the One Big Beautiful Bill Act in July 2025. The Congressional Budget Office projects this law will cut federal Medicaid spending by $886.8 billion over ten years. The law provides $50 billion in rural health grants. However, strict limits may restrict how much hospitals actually benefit.
This article was produced with the assistance of AI and reviewed by our editorial team.
Sources
Related: Rural Maternity Care Faces Growing Strain Across the United States as Hospital Distances Mount
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