New York leads the nation in rural hospital closures over the last two years

The Senator blames hostile funding mechanisms for healthcare for the claimed "worse" rural hospital outlook in the US.

THE STATEMENT

“New York’s current trajectory and hostile funding mechanisms have pushed our healthcare infrastructure to the brink, leaving us leading the entire nation in rural hospital closures over the last two years.”
Jake Ashby, State Senator

THE VERDICT: FALSE

The nugget of truth

New York’s rural healthcare system has faced genuine financial pressure and consolidation in recent years. Nationally, data compiled by the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Planning and Evaluation (ASPE) found that about 8% of rural hospitals have closed or converted since 2010, and comprehensive tracking by the University of North Carolina’s Cecil G. Sheps Center for Health Services Research shows that nearly 200 rural hospitals have closed or converted nationwide since 2005.

The Data & Context

That closure total is not concentrated in New York. Sheps Center data (via RHT Compass) shows Texas (25 closures), Tennessee (14), North Carolina (12), California (10) and Missouri (10) have absorbed the overwhelming majority of the nation’s rural hospital shutdowns since 2005. New York’s own total is a small fraction of those figures and sits well below the states leading the country in closures — the opposite of Sen. Ashby’s claim that New York is “leading the entire nation.”

Top 5 states by rural hospital closures since 2005. Source: Cecil G. Sheps Center for Health Services Research, via RHT Compass.

The pattern tracks closely with each state’s Medicaid policy. The American Hospital Association reports that more than 74% of rural hospital closures nationwide have occurred in states that did not expand Medicaid under the Affordable Care Act. New York is a Medicaid expansion state, and its rural safety-net hospitals have avoided the acute, widespread closures seen in non-expansion states such as Texas, Tennessee and Georgia.

Source: American Hospital Association.

Understanding the Pressures

That doesn’t mean New York’s rural hospitals are free of strain. Healthcare analytics firm Chartis notes that rural hospitals nationwide, New York’s included, face continuous pressure from thin inpatient margins, the loss of obstetric units as staffing shortages and declining birth rates force labor-and-delivery closures, and reimbursement cuts tied to uncompensated care and sequestration. Those are real, ongoing vulnerabilities, but they are distinct from the specific claim that New York leads the nation in hospital closures.

Conclusion

Rural New York hospitals do face localized service cutbacks, financial headwinds and recruitment challenges. But national tracking data shows New York’s rural hospital closure count remains far below that of the Southern and Midwestern states that lead the country, making Sen. Ashby’s claim that New York leads the nation in rural hospital closures false.

Sources

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