Rural Hospital Sustainability Index Analysis

Trends in Rural Hospital Financial Viability, Community Essentiality, and Patient Outmigration

In 2019 and 2020 Guidehouse analyzed the correlation of financial viability and essentiality of rural hospitals across the country.

According to the most recent analysis 25% of rural hospitals nationwide are at a high risk of closing unless their financial situations improve. Of these hospitals, 82% are considered highly essential to their communities.


2020 Analysis Insights

Additional insights from the 2020 analysis of migration patterns of patients who live in rural counties in six states show:

  • 76% of patients living in rural counties with a local hospital outmigrated for care (e.g., left their local area and hospital to receive care elsewhere), compared to 35% and 23% of suburban and urban patients, respectively
  • As more complex care often can’t be provided at local hospitals, the analysis divided rural outmigration data into three levels based on patient acuity. We found that while rural hospitals should be able to keep most Level 1 cases (lower acuity conditions per which the hospital provides associated services), 68% of patients still outmigrated for this level of care.

Read the full analysis by year:

2020 Rural Hospital Analysis

2019 Rural Hospital Analysis

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