Rural Health Care Statistics in US 2025 | Key Facts

Rural Health Care in US 2025

Rural health care in the United States faces an unprecedented crisis in 2025, as communities across America struggle with hospital closures, workforce shortages, and deteriorating access to essential medical services. Approximately 46 million Americans live in rural areas, representing about 14 percent of the total U.S. population, yet these communities face disproportionate challenges in accessing quality health care. Over the past year alone, 18 rural hospitals have closed or converted to operating models that exclude inpatient care, bringing the total closures since 2010 to 182 hospitals. This alarming trend has created vast medical deserts where residents must travel 20 to 40 miles farther for basic services, with some specialized care requiring journeys of over 50 miles.

The financial instability plaguing rural hospitals has reached critical levels, with 46 percent of all rural hospitals operating at a negative margin as of 2025, and an additional 432 hospitals identified as vulnerable to closure within the next six to seven years. According to the latest analysis from the Center for Healthcare Quality and Payment Reform, 756 rural hospitals nationwide are at risk of closure due to financial problems, with more than 40 percent facing immediate risk within the next two to three years. The workforce crisis compounds these challenges, as 66.5 percent of primary care Health Professional Shortage Areas are located in rural communities, and rural areas have only 30 physicians per 100,000 people compared to 263 per 100,000 in urban areas. The combination of hospital closures, workforce shortages, and inadequate reimbursement creates a perfect storm that threatens the viability of rural health care in the US for generations to come.

Interesting Rural Health Care Facts and Latest Statistics in the US 2025

Data Source: Chartis Center for Rural Health (February 2025), Center for Healthcare Quality and Payment Reform (December 2025), Commonwealth Fund (November 2025), Health Resources and Services Administration (October 2025), U.S. Government Accountability Office (September 2025), American Hospital Association (June 2025), Centers for Disease Control and Prevention (2025)

The rural health care statistics in the United States for 2025 reveal a health system in crisis. With 182 rural hospitals having closed since 2010, including 18 in 2024 alone, communities are losing access to emergency services, inpatient care, and essential medical procedures. The financial vulnerability is staggering, with 46 percent of rural hospitals operating at a loss and 432 hospitals vulnerable to closure in the next six to seven years. Even more alarming, 756 rural hospitals are now at risk of closure, with over 300 facing immediate risk within the next two to three years. States with the highest vulnerability include Texas with 47 vulnerable hospitals, Kansas with 46, Mississippi with 28, and Oklahoma with 23. When measured as a percentage, Arkansas leads with 50 percent of its rural hospitals vulnerable, followed by Mississippi at 49 percent and Kansas at 47 percent.

The workforce shortage crisis affecting rural health care in the US is equally devastating. With 66.5 percent of primary care Health Professional Shortage Areas located in rural communities and 61.85 percent of mental health shortage areas in rural regions, residents face severe provider shortages. Rural areas have only 30 physicians per 100,000 people compared to 263 per 100,000 in urban settings – nearly a nine-fold difference. Over 50 percent of rural doctors are aged 50 or older, and a projected 23 percent decline in rural physicians by 2030 due to retirements will devastate an already fragile system. The maternity care crisis has reached catastrophic levels, with 116 labor and delivery units closing since 2020, including 27 in 2025 alone, leaving only 41 percent of rural hospitals still offering maternity services. More than 50 percent of rural counties lacked hospital-based obstetric services in 2018, forcing pregnant women to travel over 30 minutes in 70 percent of cases, and over 50 minutes in 20 percent of cases to reach the nearest facility. The federal government has responded with the $50 billion Rural Health Transformation Program distributed across all 50 states from 2025-2030, though questions remain whether this funding will arrive in time to prevent further collapses.

Rural Hospital Closures and Financial Vulnerability in the US 2025

Data Source: Chartis Center for Rural Health (February 2025), U.S. Government Accountability Office (2025), USDA Economic Research Service (January 2025), American Hospital Association (June 2025), Becker’s Hospital Review (December 2025)

Rural hospital closures in the United States during 2025 have accelerated at an alarming pace, with 18 facilities closing or converting to non-inpatient models in 2024 alone, continuing a devastating trend that has eliminated 182 rural hospitals since 2010. Between 2005 and 2023, 146 rural hospitals either closed completely or converted to non-acute care models, with 81 shutting down entirely. The financial crisis driving these closures is severe, as 48 percent of rural hospitals operated at a financial loss in 2023, and current projections show 46 percent with negative operating margins. The most vulnerable states include Texas with 47 hospitals at risk, Kansas with 46, Mississippi with 28, Oklahoma with 23, and Georgia with 22. When measured as a percentage of each state’s rural hospitals, Arkansas leads at 50 percent vulnerable, Mississippi at 49 percent, Kansas at 47 percent, and Tennessee at 44 percent.

The financial pressures intensified in 2025 as reimbursement cuts stripped an additional $159 million from rural hospital revenues and eliminated nearly 2,700 jobs. California rural hospitals lost $14.1 million, Illinois $10.6 million, and Wisconsin $10.5 million to charity care reimbursement cuts alone. The shift to Medicare Advantage has created additional challenges, with 39 percent of rural Medicare-eligible individuals now enrolled in these plans, which typically reimburse at lower rates than traditional Medicare’s cost-based reimbursement. The human cost of closures is staggering, as residents now travel a median of 23.9 miles for general inpatient care (up from 3.4 miles), and 44.6 miles for specialized alcohol and drug treatment (up from 5.5 miles). Research shows that 75 percent of rural hospital closures between 2010 and 2021 occurred in states that refused Medicaid expansion or where expansion had been in place for less than a year, demonstrating the critical importance of Medicaid funding for rural hospital survival in the US.

Rural Health Care Workforce Shortages in the US 2025

Data Source: Health Resources and Services Administration (October 2025), Commonwealth Fund (November 2025), National Rural Health Association (June 2025), Association of American Medical Colleges (2024), Rural Health Information Hub (2025)

The rural health care workforce shortage in the United States in 2025 represents one of the most severe crises facing American medicine. With 66.5 percent of primary care Health Professional Shortage Areas located in rural communities and 61.85 percent of mental health shortage areas in rural regions, tens of millions of Americans lack adequate access to essential providers. Rural areas have only 30 physicians per 100,000 people compared to 263 per 100,000 in urban settings, creating a nearly nine-fold disparity that leaves communities medically underserved. For primary care specifically, rural areas average just 4 physicians per 10,000 people, far below the national average of 8.4 and the recommended guideline of 6.9. In some designated shortage areas, the ratio plummets to as low as 0.12 physicians per 10,000 people, meaning effectively no access to primary care.

The aging rural physician workforce compounds the crisis, with over 50 percent of rural doctors aged 50 or older and a projected 23 percent decline in rural physicians by 2030 due to retirements. Physician burnout rates are 82.3 percent higher among doctors compared to other occupations, driving even younger physicians out of practice or away from rural areas. The Association of American Medical Colleges projects the United States will face a shortage of up to 86,000 physicians by 2036, with rural areas bearing a disproportionate burden. According to Joint Economic Committee calculations, 91 percent of all rural counties nationwide face primary care physician shortages, and in New Mexico that figure reaches 96 percent. Beyond physicians, critical shortages exist across all healthcare professions, with projected shortfalls of nearly 500,000 home health aides, 95,000 nursing assistants, 98,700 medical and lab technologists, and 29,400 nurse practitioners by 2025. Social factors worsen recruitment and retention, as 58 percent of rural populations live in childcare deserts compared to 44 percent in urban areas, making it difficult for healthcare workers with families to relocate to rural communities in the US.

Rural Maternity Care Crisis and Labor Delivery Closures in the US 2025

Data Source: Center for Healthcare Quality and Payment Reform (November 2025), Fierce Healthcare (November 2025), Boston University School of Public Health (November 2025), Chartis Center for Rural Health (2025), American Hospital Association (2025)

The rural maternity care crisis in the United States in 2025 has reached catastrophic levels, with 116 labor and delivery units closing in rural hospitals since the end of 2020, including 27 units that closed or announced closures in 2025 alone. This represents an increase from 21 closures in 2024 and follows 34 closures in 2023, the highest single-year total in the past five years. Between 2011 and 2023, 293 rural hospitals stopped providing obstetric services, representing 24 percent of the nation’s rural OB units. As a result, only 950 rural hospitals still offer labor and delivery services, representing just 41 percent of the country’s 2,396 hospitals with rural classifications. Florida and Pennsylvania have been hit hardest, with 57 percent and 42 percent of their rural hospitals stopping OB services during the review period, respectively. Eleven states lost 10 or more OB units during this timeframe.

The consequences for pregnant women in rural America are severe and potentially life-threatening. More than 50 percent of rural counties lacked hospital-based obstetric services by 2018, and that percentage has only worsened. Without local labor and delivery services, approximately 70 percent of rural pregnant women face travel times exceeding 30 minutes to reach the nearest hospital, while about 20 percent must travel over 50 minutes. In contrast, most urban residents need only 20 minutes or less to reach an alternative hospital. By 2030, the projected supply of OB/GYNs in rural areas is expected to meet only 50 percent of demand, essentially guaranteeing that half of rural pregnant women will lack adequate access to obstetric care. The financial pressures driving closures are immense, as Medicaid reimbursement for inpatient obstetrics care in rural hospitals was only 63 cents on the dollar in 2024, yet Medicaid pays for nearly 50 percent of births in rural areas. Over 120 rural hospitals that still deliver babies are currently operating with negative margins on their maternity services, placing them at high risk of joining the growing list of rural maternity care deserts in the US.

Rural Health Outcomes and Population Health Disparities in the US 2025

Data Source: Centers for Disease Control and Prevention (2025), National Institute of Health (2025), U.S. Department of Agriculture (2024), Commonwealth Fund (2025), Texas Tribune (December 2025)

The health outcomes for rural residents in the United States in 2025 are significantly worse than their urban counterparts across virtually every major health indicator. Rural Americans have a life expectancy that is 2 years shorter than urban residents, a gap that has widened over the past two decades. Rural areas have a higher proportion of elderly residents, with 19 percent aged 65 and older compared to 15 percent in urban areas, and the share of people aged 65 and older is expected to grow by over 40 percent by 2034. This aging population combined with limited healthcare access creates a dangerous situation. Rural residents experience higher rates of obesity, with multiple studies documenting significantly higher prevalence than urban areas. Food insecurity affects rural communities at higher rates, while cigarette smoking and poor physical activity are more prevalent in rural populations.

The chronic disease burden in rural America is substantial and worsening. Death rates from cancer, heart disease, respiratory disease, and unintentional injuries are all higher in rural areas than in urban regions. In Texas, for example, indicators of health outcomes are worsening in rural populations, with deaths from these major causes exceeding state averages. Rural residents face higher poverty rates and lower educational attainment, both of which are strongly linked to worse health outcomes and increased risk of chronic disease. The uninsured rate is higher in rural areas, with 60 of 76 Texas counties with uninsured rates over 20 percent being rural counties. Preventive care visit utilization is only 35 percent in rural areas compared to 45 percent in urban areas, meaning rural residents miss critical screening opportunities for early detection and treatment of diseases. The loss of obstetric services has documented consequences, with increases in pre-term births and longer distances traveled for obstetric care contributing to poor maternal and infant health outcomes. With 80 percent of rural America medically underserved, the health disparities between rural and urban populations in the US will only continue to widen without significant intervention.

Federal and State Responses to Rural Health Care Crisis in the US 2025

Data Source: Centers for Medicare and Medicaid Services (September 2025), Texas Tribune (December 2025), American Hospital Association (June 2025), KFF (August 2025), MACPAC (2025), HHS ASPE (October 2024)

Federal and state responses to the rural health care crisis in the United States in 2025 have focused primarily on the $50 billion Rural Health Transformation Program included in H.R. 1 legislation. This massive allocation, to be distributed across all states by 2030, represents the largest federal investment in rural health infrastructure in decades. The program splits funding equally, with $25 billion distributed equally across all states and another $25 billion awarded based on state-specific applications. Texas received the largest portion of the initial rollout at $281 million, with the state planning to add more than a thousand rural healthcare positions. The Centers for Medicare and Medicaid Services oversees the program with strategic goals focused on chronic disease management, workforce development, digital innovations, and delivery system reforms.

Other federal programs provide critical support for rural health care in the US. The National Health Service Corps has 38 percent of its field strength serving in rural settings as of September 2023, while the Nurse Corps has 20 percent in rural areas. Medicaid coverage protects over 16 million people in rural communities, helping address barriers to care and sustaining rural hospitals. However, proposed Medicaid cuts in H.R. 1 would result in 1.8 million individuals in rural communities losing coverage by 2034, and select provisions would cut $50.4 billion in federal Medicaid spending on rural hospitals over 10 years. State Medicaid expansion has proven crucial, with studies showing it is associated with improved hospital financial performance, lower risk of closure, and increased access to services. The ACA Marketplace provides another coverage option, though rural counties average only 2.5 insurers per county compared to 3.1 in metro counties. The USDA Community Facilities Program provides financial support, and research shows hospitals receiving this funding have higher survival rates. Medicare telehealth expansions initiated during COVID-19 have been extended, though rural areas face barriers including limited broadband access and inadequate reimbursement for these services.

Telehealth and Technology Solutions for Rural Health Care in the US 2025

Data Source: Commonwealth Fund (November 2025), Rural Health Information Hub (2025), USDA (2023), HHS ASPE (October 2024), NIHCM Foundation (2025)

Telehealth solutions for rural health care in the United States in 2025 offer significant potential to address access barriers, though substantial obstacles remain. Currently, only 2 in 10 working-age rural adults reported receiving primary care via telehealth in the past 12 months, compared to 3 in 10 nonrural residents, a statistically significant difference that highlights the rural-urban telehealth divide. Prior to the COVID-19 pandemic, Medicare fee-for-service telehealth utilization was less than 1 percent, but emergency flexibilities during the pandemic demonstrated the technology’s potential. While utilization has decreased from pandemic peaks, it remains elevated, and Medicare has extended many telehealth flexibilities beyond the emergency period. States have discretion to set Medicaid telehealth policies, resulting in wide variation in coverage and reimbursement.

The primary barrier to expanding telehealth in rural America is inadequate broadband infrastructure, with 17 percent of rural residents lacking broadband internet access compared to only 1 percent in urban areas. The USDA has allocated $667 million for rural broadband infrastructure to address this gap, but deployment takes years. Even where internet is available, clinicians cite burdensome and time-prohibitive licensing requirements for providing telehealth across state lines. Reimbursement remains inadequate in many cases, making it difficult for rural clinicians to sustain telehealth delivery financially. Despite these challenges, telehealth is expanding in specific areas, particularly mental health services where provider shortages are most acute. Rural Health Clinics can now provide nearly 20 different services via telehealth, including mammograms, mental health care, and substance use disorder treatment. Innovative programs like Remote Area Medical mobile dental and medical clinics bring services directly to underserved communities, while Pennsylvania’s Rural Health Model tests alternative payment approaches. Successfully scaling telehealth to address rural health care access in the US will require coordinated investment in broadband infrastructure, simplified licensure processes, and adequate reimbursement for virtual services.

Long-Term Outlook and Sustainability for Rural Health Care in the US 2025

Data Source: Center for Healthcare Quality and Payment Reform (December 2025), Association of American Medical Colleges (2024), Boston University School of Public Health (November 2025), Centers for Disease Control and Prevention (2025)

The long-term outlook for rural health care in the United States in 2025 is deeply concerning without fundamental reforms to hospital financing and workforce development. With 432 rural hospitals vulnerable to closure in the next six to seven years, and over 300 facing immediate risk within two to three years, the accelerating pace of closures threatens to create vast regions where hospital-based care is completely unavailable. Ten states already have over 50 percent of their rural hospitals at risk, and the situation will worsen as the rural population ages. By 2034, the number of rural residents aged 65 and older is projected to increase by over 40 percent, dramatically increasing demand for healthcare services precisely as supply contracts. The projected shortage of up to 86,000 physicians by 2036 will disproportionately impact rural areas, where recruiting and retaining providers is already nearly impossible.

The root causes of rural hospital financial distress in the US center on inadequate payments from private insurance plans, which pay rural hospitals less than the cost of delivering services. Medicare and Medicaid underpayment contributes, but the primary driver is commercial insurance. Solutions must address this fundamental problem, with proposals for Standby Capacity Payments to support fixed costs of essential services and Service-Based Fees for variable costs. The graduate medical education funding formula, capped since 1997, directs $15 billion in annual Medicare GME spending without regard to shortage areas, perpetuating physician maldistribution. The declining U.S. birth rate, which fell to a record low below 1.6 children per pregnant person in 2024, with 687,000 fewer births than 2007, complicates the maternity care picture. While fewer births may rationally support fewer maternity beds, rural maternity ward closures have not been done systematically in consultation with communities, often driven by corporate cost-cutting with no plan for how communities will be served. Addressing the crisis requires multi-sector partnerships involving business, government, philanthropy, universities, community colleges, and local leaders working together to recruit health professionals and build sustainable models. The Rural Health Transformation Program’s $50 billion investment represents a critical opportunity, but without addressing underlying payment inadequacies and workforce shortages, rural health care in the US faces an existential threat that could leave tens of millions of Americans without access to essential medical services.

Disclaimer: This research report is compiled from publicly available sources. While reasonable efforts have been made to ensure accuracy, no representation or warranty, express or implied, is given as to the completeness or reliability of the information. We accept no liability for any errors, omissions, losses, or damages of any kind arising from the use of this report.

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