AI-assisted summary Eight rural Mississippi hospitals are at risk of closing due to financial strain.

The hospitals are at risk because of low Medicaid payer mix and/or consecutive years of negative profit margins.

Recent healthcare legislation reducing Medicaid funding is expected to exacerbate the financial challenges faced by these hospitals.

Medicaid is a significant source of healthcare coverage for Mississippi residents, particularly kids and those in rural areas.

Eight rural Mississippi hospitals are considered “at risk” of closing, according a report from a reputable center for health services research.

U.S. senators requested a list of the rural hospitals from each state from the center and attached it in a letter to President Donald Trump, among others.

Here are the hospitals in Mississippi and why they’re being considered.

How is “at-risk” of closing defined?

A rural hospital is labeled as at risk when it meets one or both of two criteria, according to the documents: the hospital is in the top 10% Medicaid payer mix of rural hospitals across the country, and that the hospital has experienced three consecutive years of negative total margin.

What hospitals are at-risk in Mississippi?

Here are the eight hospitals deemed at-risk in Mississippi:

Alliance Healthcare System, Holly Springs. Delta Health-Northwest Regional, Clarksdale. Baptist Memorial Hospital-Booneville, Booneville. Greenwood Leflore Hospital, Greenwood. Baptist Anderson Regional Medical Center, Meridian. Highland Community Hospital, Picayune. Panola Medical Center, Batesville. Baptist Memorial Hospital-Yazoo, Yazoo City.

Alliance in Holly Springs was among the 10% Medicaid payer mix. All of the others had a negative total margin for three consecutive years. Only one on the list — Panola Medical Center — met both criteria.

What center for health services research released the info?

The Cecil G. Sheps Center for Health Services Research is part of the University of North Carolina at Chapel Hill.

The center, according to their site, seeks to improve the health of individuals, families, and populations by understanding the problems, issues, and alternatives in the design and delivery of health care services.

What was the purpose of the letter?

U.S. Sens Edward J. Markey, Ron Wyden, Jeffrey A. Merkley, and Charles E. Schumer wrote to President Trump, Majority Leader John Thune, and Speaker of the House Mike Johnson in response to the reconciliation package that ultimately Trump signed on the Fourth of July. They sent the letter on June 12.

The senators argued that the health care cuts could impact vulnerable, rural hospitals.

“Enacting these drastic health care cuts that will kick millions of people off their health insurance coverage, rural hospitals will not get paid for the services they are required by law to provide to patients,” authors wrote, adding that the hospitals will face “deeper financial strain that could lead to negative health outcomes for the communities they serve.”

What will the legislation do?

The bill, now signed into law, is projected to cut $1 trillion mostly from Medicaid and Affordable Care Act insurance plans and eliminate insurance coverage for 11.8 million people over the next decade, according to the nonpartisan Congressional Budget Office, as reported by USA Today.

Can you afford to live in Mississippi? Minimum wage isn’t enough for many people. What to know

How many people in Mississippi get Medicaid?

According to KFF, formerly known as the Kaiser Family Foundation, about 667,000 people in Mississippi get health care via Medicaid and the Children’s Health Insurance Program (CHIP).

Total spending in the state is $6.3 billion, and about $5.2 billion comes from federal funding.

More than half of recipients (52%) are kids, and most (58%) live in rural areas.

According to KFF, Medicaid in Mississippi covers:

74% of nursing home residents.

57% of births.

48% of children.

38% of working adults with disabilities.

26% of Medicare beneficiaries.

14% of adults ages 19-64.

More than half of adult Medicaid recipients in Mississippi — 58% — are working, per KFF.

Tom Ackerman covers breaking news and trending news along with general news for the Springfield State Journal-Register. He can be reached at tackerman@gannett.com.

Bonnie Bolden is the Deep South Connect reporter for Mississippi with Gannett/USA Today. Email her at bbolden@gannett.com.

Jaymie Baxley

NC Health News

Successful rural county health program could go statewide—if politics don’t get in the way

In 2022, North Carolina launched an experimental initiative to address the nonmedical health needs of low-income residents by using Medicaid dollars.

This first-in-the-nation effort, known as the Healthy Opportunities Pilot, has provided assistance to nearly 30,000 people across three largely rural regions of the state. Beneficiaries get deliveries of food, rides to doctor’s appointments and other services that are designed to combat the various social, economic and geographic issues that contribute to health disparities.

Only 33 of the state’s 100 counties are included in the pilot, but more communities could be covered if lawmakers vote to expand it.

The $650 million pilot was created through a waiver, issued by the Centers for Medicare and Medicaid Services, that allowed the N.C. Department of Health and Human Services to use federal Medicaid funds — usually earmarked for medical expenses — to address needs like food, transportation and housing. During the final weeks of the Biden administration, CMS approved a waiver extension that gives the department the option of taking the program statewide.

Kody Kinsley, the former NCDHHS secretary who spearheaded the program’s rollout, said expanding the initiative will require the blessing of the N.C. General Assembly, which must agree to match whatever funding is ultimately provided by the federal government.

Still, he believes the results will justify the investment. Early research shows the state is spending about $85 less in medical costs per month for each person participating in the pilot. Participation in the program has also been “associated with decreased emergency department utilization,” according to a report from the Cecil G. Sheps Center for Health Services Research at the University of North Carolina.

“This is something worth doubling down on,” Kinsley said in a recent interview with NC Health News. “It’s a huge investment for the federal government, but it’s also a huge affirmation that our strategy is working.”

While the waiver extension allows the pilot to continue through 2029, the new administration in Washington has Medicaid cuts in its sights — making the program’s future far from secure.

Boosting small businesses

Three agencies facilitate services for program participants in the pilot regions. These organizations — Access East, Community Care of the Lower Cape Fear and Impact Health — act as intermediaries, coordinating the distribution of goods and services through a network of more than 140 nonprofits and community partners.

Laurie Stradley, executive director of Impact Health, said the Healthy Opportunity Pilot is unique in that it was offered in rural areas of the state first, which is “not always the norm for pilot programs.” Her agency is the largest of the three network leads, covering 18 counties across the mountainous Western North Carolina.

She said the pilot has had a “ripple effect” on the region’s economy. For example, the food participants receive through the program is often purchased from local growers.

“We’ve heard from some of our produce providers and some of the farms themselves that Healthy Opportunities allows them to make plans and have a market to sell their fresh local produce in a way that is more consistent than some of their other marketplaces,” she said. ”They know that they’re going to get a consistent order from the nonprofits we work with.”

That weekly box of food has a ripple effect in the local economy in other ways.

“We had one mother say, ‘You know, because I know that food box is coming on Friday, I feel safe paying my rent on Wednesday,’” Stradley said. “Because she knows her family is going to eat, she can safely make that investment, which instantly improves her health stability and prevents her from getting behind in rent.”

Families in the program can also then redirect their dollars to paying utilities. Utility shutoffs are a common cause of people being evicted from their apartments, Stradley explained.

“If you know the power gets turned off, landlords are not often going to allow folks to stay in that space,” she said. “So when we can help people get up to date on their utilities, then they’re also more likely to be able to stay housed.”

But there’s got to be somewhere for people to live in the first place, which was difficult in western North Carolina even before the remnants of Hurricane Helene ravaged the housing stock.

A lifeline after disaster

Participation in the Healthy Opportunities Program grew in the aftermath of Helene, which displaced many families in the region.

“The folks that were already receiving some degree of services are finding that they have more needs,” Stradley said. “Then we also have folks who are newly eligible for Medicaid and the Healthy Opportunities Pilot because they’ve lost jobs or housing or other points of stability in their home lives that have increased demand for HOP services.”

At the same time, the disaster made it harder to provide services — housing in particular.

“Formerly, we were doing housing navigation and support for a slice of the regional population, but now we have hundreds of families competing for spaces because their housing has been damaged or lost,” Stradley said. “So it’s also harder for those folks who are already eligible to get access to some of the services like home repairs, for example, because our contractors in this region are flat out of availability.”

Housing has long been one of the most difficult needs to meet in western North Carolina, owing in large part to the region’s scant inventory of homes and dearth of affordable rental options.

“In the early days and the early allowances for healthy opportunities and housing, we really focused on people who were in unstable situations or unhoused,” Stradley said. “What we’re recognizing is that we need more emphasis on keeping people housed through things like home repairs and remediation.”

She offered the example of a family that has a young child with asthma.

“They get home from school and by after-dinner time they’re starting to have some trouble breathing and starting to have an asthma attack — and they’re going to wind up in the emergency room,” she said.

The Healthy Opportunities Pilot can help that family tackle the environmental triggers in the house — such as mold, a common problem in the mountains. The family can get as much as $2,900 to address those issues, which is about the cost of one emergency room visit.

“There’s a program in that called Breathe Right that helps to remove any moldy carpet or other mold mitigation that needs to happen in the house, and brings in filters to systems and vacuums that have a HEPA filter on them, hypoallergenic covers for pillows and all those sorts of things,” Stradley said. “And then the child will see a great decline in emotional, environmental triggers. And then they’re not going to the emergency room, [instead] staying in school, all those good things.”

Despite the challenges, Stradley said she’s excited about the possibility of the pilot expanding to other parts of the state.

“We’re already seeing indications that if we don’t spend these funds on food and housing and transportation, we are going to spend these funds on clinical care, diagnosis and long-term health care,” she said. “The more we can invest in making sure that young people have a safe place to sleep and healthy food to eat means that they are more likely to grow up and grow out of these programs.”

Model for the nation

The pilot is one of the first large-scale tests of whether providing nonmedical services can boost health outcomes and cut health care costs, and its results could inform Medicaid policies in other states.

“What every other state has done is really taken one specific domain and leaned in really hard,” Kinsley said, noting that initiatives in other states have focused exclusively on needs like food or housing. “North Carolina has the widest list of services that can be paid for with these types of Medicaid dollars.”

The early success of the pilot, he added, has “given the federal government confidence that we can take this statewide and continue to push forward.”

Kinsley’s successor, NCDHHS Sec. Devdutta Sangvai, supports expanding the program to other regions of the state, but he said that’s not going to happen overnight.

“We have this waiver now, which gives us options, and now we have to think about how we exercise the options that CMS has given us,” he said. “It’ll definitely require partnership with the General Assembly to understand where those priorities are.”

“The challenge,” he added, “is we’re not going to be able to do everything all at once, and we’re not going to be able to do it at 100 percent all at once.”

In the coming months, Sangvai said, he hopes to build consensus around the program, which faces an uncertain future under the new presidential administration.

Trump has said little about his plans for Medicaid, but many of his cabinet appointees have signaled interest in cutting funding for the program — a move that would make pilot expansion a tougher sell for state lawmakers and force them to prioritize medical expenditures.

Stradley hopes that won’t happen. She believes the pilot could “become more effective and more efficient” if it’s allowed to grow.

“There will be so much more opportunity for collaboration and coordination and reduction in the sort of administrative and overhead costs that come with the early stages of a pilot,” she said. “We hear all the time that all eyes are on us, for those of us doing this work in North Carolina, and it’s true. We really are shaping the way that this can be done, and other states are going to learn from us.”

Data shows Oregon hospitals in Silverton, Seaside, Madras, and Hermiston among more than 300 rural hospitals nationwide at disproportionate risk of closure, conversion, or service reductions

Washington (June 12, 2025) – U.S. Sens. Ron Wyden and Jeff Merkley (both D-Ore.) today joined with U.S. Sen. Edward J. Markey (D-Mass.) and Democratic Leader Chuck Schumer (D-N.Y) to release new data concluding that health care cuts in the Republican budget bill could place more than 300 rural hospitals across the U.S. at disproportionate risk of closure, conversion, or service reductions.

The data from the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill follows House Republicans’ passage of a budget bill that would impose the largest cuts to health care in U.S. history, slashing funding for Medicaid and the Affordable Care Act by more than $1 trillion and triggering more than $500 billion in Medicare cuts. The analysis released today is based on financial indicators including: share of Medicaid patients served, previous years of negative total margins, and data modeling on future financial distress.

“Hospitals are often the backbone of rural communities in Oregon and across the nation. They are often the largest employer in a rural community, and more often than not, many of the families they serve count on Medicaid for health care,” said Wyden, Ranking Member of the Senate Finance Committee. “The Republican bill would hit rural Oregon like a wrecking ball, and among the first to suffer would be the rural hospitals and those they serve and employ who are already walking on an economic tightrope.”

“As I hold town hall meetings in each of Oregon’s 36 counties, I frequently hear about struggles folks have in accessing health care in their communities. This isn’t a red state or blue state issue. Medicaid helps every state – especially rural communities,” said Merkley, Ranking Member of the Budget Committee. “More than 300 rural hospitals will be at risk of shutting down – in Oregon and across the country – if Republicans betray middle class families and make these drastic cuts to Medicaid, all so that billionaires can pay less in taxes. This is the Republican plan: families lose, and billionaires win.”

The lawmakers also sent the data in a letter to President Trump, Leader John Thune, and Speaker Mike Johnson, writing, “Addressing the crisis in rural health care access is a national, bipartisan priority, and it should be bipartisan to not worsen that crisis. However, if your party passes these health care cuts into law, Americans in rural communities across the country risk losing health care services and jobs supported by their local hospitals. We urge you to read the attached report and reconsider your position. It is not too late to stop these cuts. Billionaire tax breaks are not worth the cost to American lives and livelihoods.”

The response from the Cecil G. Sheps Center for Health Services Research states, “Substantial cuts to Medicaid or Medicare payments could increase the number of unprofitable rural hospitals and elevate their risk of financial distress. In response, hospitals may be forced to reduce service lines, convert to a different type of health care facility, or close altogether.”

The data shows 338 rural hospitals at particular risk of closure, conversion, or service reduction from substantial health care cuts because the hospitals either take a high relative share of Medicaid patients, or have experienced three consecutive years of negative total margins, or both. This includes four hospitals in Oregon: Silverton Hospital, Providence Seaside Hospital, St. Charles Madras, and Good Shepherd Medical Center in Hermiston.

In the face of these Republican cuts, a majority of adults living in rural areas are concerned that health care cuts will “negatively impact hospitals, nursing homes, and other health care providers in [their] community,” the senators wrote in their letter to Trump, noting that rural hospitals are struggling. In 2023, there were 50 fewer rural hospitals than in 2017, and a lack of health care access in rural America is contributing to worse health outcomes. Faced with additional cuts to their revenue, many rural hospitals may be forced to stop providing certain services, including obstetric, mental health, and emergency room care, convert to clinics or standalone emergency centers, or close altogether. Rural hospitals are often the largest employers in rural communities, and when a rural hospital closes or scales back its services, communities are not only forced to grapple with losing access to health care, but also with job loss and the resulting financial insecurity.

The lawmakers sent a letter to the Sheps Center director on June 4, 2025, requesting the Center’s expert analysis of how this bill will impact rural hospitals and the communities they serve, particularly inquiring about which rural hospitals in the country treat the highest share of Medicaid recipients; how many rural hospitals are currently in financial distress or at risk of closure; and if the health care cuts in the House-passed budget reconciliation bill were to become law, would the rural hospitals with the highest share of Medicaid recipients or that are currently in financial distress face risk of closure or have to reduce services.

The senators’ letter and data are here. The Sheps Center response is here.

Hundreds of hospitals in rural areas are at risk of closing under proposed Medicaid and Medicare cuts, according to data from the Cecil G. Sheps Center at the University of North Carolina at Chapel Hill.

The data was compiled upon request from Senate Democrats who outlined the impacts of potential rural health care closures in a letter to Republicans behind the “One Big Beautiful Bill Act.”

The research noted that 338 rural hospitals nationwide were at risk of closing.

According to researchers, hospitals that made the list met one or both of the following financial criteria:

The hospital is in the top 10% Medicaid payer mix of rural hospitals across the country The hospital has experienced three consecutive years of negative total margin.

All but four states were impacted: Maryland, New Jersey, Rhode Island and Vermont, according to the data.

Five hospitals in North Carolina made the list, including Person Memorial in Roxboro and UNC Health Chatham in Siler City.

Hospital officials from both health care systems on Monday told WRAL News the data presented doesn’t paint an accurate picture of their specific facilities, due to involvement with larger hospital systems.

A statement from Person Memorial Hospital, a Duke LifePoint Healthcare facility, read as follows:

“Medicaid is a safety net for many patients we serve at Person Memorial Hospital and ensures our community’s most vulnerable – including children, pregnant women, seniors in nursing homes and individuals with disabilities – have access to critical health care services. While it is true that Medicaid funding cuts would disproportionately affect patients and healthcare providers in rural communities like ours, it is premature to speculate or discuss any impact on our hospital or its services. We are stable and fortunate to be part of a larger organization that provides significant resources and support so we can continue to grow and invest in our hospital, services and community. We take our role as an advocate for our patients very seriously and continue to be in close contact with key officials about the importance of maintaining Medicaid funding and protecting our community’s access to care.”

A spokesperson with UNC Health further told WRAL News, “UNC Health Chatham is not in danger of closing.”

The statement continued:

“UNC Health remains committed to ensuring all our hospitals across the state remain open and continue providing important care for patients.

That report was written without consultation from UNC Health leadership or the ability to review and comment on the disposition of the UNC Health hospitals named in the report.

It is true that the magnitude of federal cuts to various health programs, including the Medicaid program, could have an adverse impact on hospitals, especially rural hospitals, across the country. However, those owned by large health systems are much better protected against the risk of closure.”

Rural hospitals at risk of closing can potentially keep their emergency rooms and provide limited inpatient care by being designated a Rural Emergency Hospital (REH).

The designation was established by Congress in 2020, with the first hospital receiving a REH designation in 2023.

The model has been used more than 30 times nationwide, according to UNC Sheps Center research.

North Carolina currently does not have a REH.

WRAL investigated the efforts underway to potentially reopen Martin General Hospital in Martin County as a REH in 2024.

County officials at the time told WRAL it would be a first for the country, as no hospital has ever closed entirely before reopening as a REH.

Martin General Hospital abruptly closed in August 2023 after Quorum Healthcare filed for bankruptcy and closed the facility.

It has since remained fenced off as residents told WRAL News they are hopeful another health care system will step in to reopen the emergency department.

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