Sixteen rural hospitals in California are at risk of closure, with five at risk of closing immediately. That’s according to a report from the Center for Healthcare Quality and Payment Reform.

The report says California has had two rural hospitals close since 2015. The state still has 59 open rural inpatient hospitals, and 22 hospitals have cut or lost services. Many other states are faring worse than California, the report continues. Texas has 84 hospitals at risk of closing, with 26 being at risk of immediate closure. Kansas has 84 hospitals at risk of closure, and 28 are at risk of immediately closing.

Notably, Utah, Maryland, Delaware and New Jersey have no hospitals at risk of closure, according to the report.

Harold Miller, CEO of Center for Healthcare Quality and Payment Reform, said rural hospitals all over the country are struggling because private health insurance plans pay hospitals less than what’s needed to cover the costs of care.

Miller declined to answer The Center Square’s questions about which California hospitals were at risk of closure. But he noted, “It is a problem in California, with low payments in a lot of cases.”

“But many people think the only problem is Medicaid, and it turns out that in many places, including in California, low payments from commercial insurance plans also cause the problem,” Miller told The Center Square Thursday.

The problem is especially prevalent at small, rural hospitals, Miller said.

“It costs more to deliver healthcare services in small, rural communities,” Miller said. “Part of that stems from the fact that there is a certain fixed cost associated with delivering essential healthcare services in any community.”

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