New Chartis Data Reveals Deepening Instability Within Rural Healthcare at Onset of Rural Health Transformation Program

CHICAGO & WASHINGTON–(BUSINESS WIRE)–#nrha26dc—Chartis, a leading healthcare advisory firm, today published new research evaluating multiple dimensions of the rural health safety net and assessing the potential impact of the Rural Health Transformation Program.

Data and analysis from the study “2026 rural health state of the state,” will be shared with members of the United States Congress, rural healthcare advocates, and hospital executives this week as part of the National Rural Health Association’s 37^th annual Rural Health Policy Institute Conference.

“The Rural Health Transformation Program is an unprecedented infusion of funding, and we’re pleased to see so many states directing their efforts at entrenched challenges such as workforce development, health outcomes, and technology modernization,” said Michael Topchik, Executive Director, The Chartis Center for Rural Health. “But our enthusiasm is tempered by the persistent vulnerability of rural hospitals and the continued erosion of access to vital services revealed in our analysis. This is a true crossroads moment for rural healthcare, with anticipated Medicaid cuts to create additional disruption.”

For more than a decade, Chartis research has explored various factors exerting downward pressure on rural hospitals and the communities they serve. This year’s study features a refresh of leading safety net indicators such as rural hospital operating margin, vulnerability, and declining access to obstetrics (OB), chemotherapy, and general surgery. Also included is an in-depth analysis of state applications for the Rural Health Transformation Program and identification of key points of emphasis.

Key findings from this study include:

• 41% of rural hospitals have a negative operating margin.
• 417 rural hospitals are vulnerable to closure.
• More than 300 hospitals have eliminated OB services, more than 300 hospitals have eliminated general surgery, and more than 450 facilities have eliminated chemotherapy.
• Medicaid reimbursements account for nearly 10% (or $3.9 million) in net revenue for the typical rural hospital.
• States view telehealth and artificial intelligence as primary drivers for addressing clinical needs, access to care, and workforce-related challenges, and are featured prominently in Rural Health Transformation programs.
• States consider interoperability among tech-enabled solutions essential, especially for rural providers that rely on a patchwork of legacy electronic health records and enterprise resource planning systems that need modernization investment.

Michael Topchik will be sharing findings from this study during the Rural Health Policy Institute Conference on Tuesday, February 10 at 1:30 pm ET. Learn more at: https://www.ruralhealth.us/events/schedule/rural-health-policy-institute

Resources
The study, “2026 rural health state of the state” is available at: https://www.chartis.com/insights/2026-rural-state-state

About Chartis
The challenges facing US healthcare are longstanding and all too familiar. We are Chartis, and we believe in better. We work with more than 900 clients annually to develop and activate transformative strategies, operating models, and organizational enterprises that make US healthcare more affordable, accessible, safe, and human. With more than 1,350 professionals, we help providers, payers, technology innovators, retail companies, and investors create and embrace solutions that tangibly and materially reshape healthcare for the better. Our family of brands—Chartis, Jarrard, Greeley, and HealthScape Advisors—is 100% focused on healthcare and each has a longstanding commitment to helping transform healthcare in big and small ways. Learn more.

Contacts

Media contact
Billy Balfour
The Chartis Center for Rural Health
wbalfour@chartis.com