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GMJ News > GMJ Briefs > Rural Healthcare System Under Siege: NEJM Study Documents Crisis-Level Practice Closures

Rural Healthcare System Under Siege: NEJM Study Documents Crisis-Level Practice Closures

GMJ
Last updated: 25/06/2026 14:26
By
Prof. Giorgi Pkhakadze
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Medical practice closure statistics showing rural hospital and clinic impacts on healthcare access
New NEJM analysis reveals growing crisis of involuntary medical practice closures affecting healthcare access. Rural hospitals face 23% closure rate as economic pressures overwhelm provider sustainability efforts. — American and Chadian military emergency departments work together during medical exercise (8495148).jpg by U.S. Army photo by Maj. Edward McBride / Public domain via Wikimedia Commons (Public domain)
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1 min read|132 words

A comprehensive analysis published in The New England Journal of Medicine has documented a critical healthcare access crisis, with nearly one-quarter of rural hospitals closing or significantly reducing services over the past decade. The research reveals that economic pressures—particularly inadequate Medicare reimbursement rates that fail to cover actual care costs in two-thirds of rural facilities—are the primary driver of these involuntary closures. Independent practices face disproportionate challenges compared to hospital-affiliated providers, as consolidation pressures force difficult decisions about practice viability. Beyond rural areas, suburban and urban practices are increasingly affected by similar financial constraints. Experts warn that without immediate policy intervention addressing reimbursement adequacy and provider sustainability, the healthcare access crisis will continue to expand, leaving vulnerable populations with diminished care availability and increased travel burdens for essential medical services.

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ByProf. Giorgi Pkhakadze
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Prof. Giorgi Pkhakadze, MD, MPH, PhD, is Editor-in-Chief of the Georgian Medical Journal and Chair of the Public Health Institute of Georgia (PHIG). He is Professor and Head of the Department of Social and Behavioural Sciences at David Tvildiani Medical University, and Secretary/Treasurer of the UEMS Section of Public Health. ORCID: 0000-0001-7609-4515.

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