2023 Virginia Rural Hospital Report

Virginia is home to 28 rural hospitals that serve their communities by providing essential medical services and boosting local economies. In 2021, these hospitals handled nearly 410,000 emergency department visits, about 48,000 inpatient admissions (amounting to more than 231,000 patient days accommodated), and directly employed more than 8,000 people in good jobs as top employers in their communities (each hospital job supports two skilled jobs in the local economy).

At the same time, rural hospitals face many challenges. They often serve less populous, more geographically isolated communities and have a patient payer mix comprised of individuals who tend to be older, sicker, poorer, and of lower socioeconomic means who heavily rely on Medicaid or Medicare, programs that reimburse below the cost of providing care. Rural hospitals also struggle to recruit and retain health care professionals, particularly amid pandemic-related staff burnout conditions. The 2023 Virginia Rural Hospital Report highlights both the many public health and economic contributions the 28 rural hospitals in the state make as well as some of the challenges they face, including the fact that more than one-fourth of rural Virginia hospitals (26 percent) had negative operating margins in 2021. Nearly one-third of rural Virginia hospitals (32 percent) operated in the red in 2020. Rural hospitals are experiencing these challenges as the national hospital sector continues to deal with the impact of COVID-related revenue losses, lower patient volumes, substantial cost increases, and staffing shortages.