From 2010 to 2025, the United States saw more than 400 hospital closures, with smaller, for-profit and safety-net facilities more likely to be among those lost.
The closure rate rose by 4 percent year over year. Hospital openings moved in the opposite direction, falling by 3 percent year over year, for a net loss of 216 hospitals and more than 24,000 beds.
Thomas Tsai, an associate professor of health policy and management, authored the Harvard study of hospital closures.
Safety-net hospitals generally care for vulnerable communities and uninsured patients.
The pattern reaches far beyond rural areas. Urban and rural hospitals shut at nearly the same rate, undercutting the view that closures are chiefly a rural problem.
Physician shortages, hospital consolidation, and shifts in Medicaid and health insurance policy are among the forces behind the closures.
When a hospital closes and patients are sent elsewhere, waiting times rise at the receiving facilities.
Maternity care has also lost capacity. More than 700 hospitals closed maternity wards between 2010 and 2024, while over 57% of rural hospitals lacked birthing services.
Nearly 36,000 births in 2024 took place at hospitals that ended maternity services within the following year. Those births accounted for 1.4% of rural births and 0.9% of urban births.
Hospitals face further pressure from Medicaid coverage losses and payment cuts. New Medicaid work requirements due to take effect in January are expected to cause millions of people to lose coverage.
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