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More hospitals across the U.S. are closing than opening, and urban hospitals are closing at the same rate as rural ones, according to a new study led by Harvard T.H. Chan School of Public Health. Further, the hospitals that close are more likely to be those serving socially vulnerable communities.

The findings are published in a research letter in JAMA on Oct. 8.

Since the passage of the One Big Beautiful Bill Act, which included changes to Medicaid policy, hospitals have been bracing to lose billions in funding, and concern has been growing over potential hospital closures. Most of this concern has centered on rural hospitals, prompting Congress to create the Rural Health Transformation Program, providing billions in state grants for these hospitals. But whether hospital closures are actually concentrated in rural areas has been little studied and remains largely unknown.

The researchers sought to fill this gap and provide a current, comprehensive picture of U.S. hospital closures and openings. To do so, they analyzed data from the American Hospital Association annual survey, characterizing hospital closures and openings occurring from 2010 to 2025.

They found that hospital closures increased by 4% year over year, and openings decreased by 3% year over year, with 432 hospitals closing and only 216 opening. The result was a net loss of 216 hospitals and more than 24,000 beds.

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