Rural hospitals face growing sustainability threats on multiple fronts, AHA says

A multitude of challenges is threatening the stability of rural hospitals in America, a report from the American Hospital Association (AHA) found.

Recruitment and retention of healthcare professionals is an ongoing challenge and expense, which is further complicated by geographic isolation. The report noted isolation could also be a barrier to professional development and continuing clinical education, and contributes to low availability of services, including primary care, behavioral health services and dental care.


According to Health and Human Services data cited in the report, while almost 20 percent of the U.S. population lives in rural areas, less than 10 percent of U.S. physicians practice in these communities.

The AHA also pointed to emerging threats like the opioid epidemic, a rise in cybersecurity threats, medical surge capacity issues caused by natural disasters and rising levels of violence within communities, noting that rural hospitals often lack sufficient medical staff and resources to respond to such emergencies.


Persistent challenges like low population density in rural areas — which results in a low patient volume — mean hospitals lack scale to cover the high fixed operating costs.

In addition, rural hospitals treat a patient population that is often older, sicker and poorer compared to national averages, characteristics that underscore the importance of local access to care and the need for resources to support the changing needs of the community.

Released in conjunction with this week’s Rural Health Care Leadership Conference, the AHA study found these complex, multifaceted obstacles are immense, requiring policymakers, stakeholders and communities to work together and innovate if they are to improve health in rural communities.

A North Carolina Rural Health Research Program report cited in the AHA study found that as of December 2018, 95 rural hospitals have closed since 2010. 


“Many rural hospitals become overburdened as challenges intensify, accumulate, and compound each other,” the report warned. “Moreover, the issues of today may hinder rural providers’ preparedness for the challenges of tomorrow.” 


Nathan Eddy is a healthcare and technology freelancer based in Berlin. 

Email the writer: [email protected]

Twitter: @dropdeaded209 

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