Rural Hospital Closures: Effects on Utilization and Medical Spending Among Commercially Insured Individuals

The objective of this study is to identify the impact of rural hospital closures on total medical spending and utilization among the commercially insured rural population. Research Design: We use a pre-post study design with a comparison group. Individual‐level Texas commercial claims data in 2014–2019 were linked to the Centers for Medicare & Medicaid Services (CMS) Provider of Services Current Files, Area Health Resource File, and Census American Community Survey. We performed an event study to test for pre-trends. Subjects: Analysis sample included commercially insured individuals 19–64 years of age residing in Texas. Measures: Total medical spending and counts of health care encounters. Results: Individuals residing in rural Texas areas affected by a hospital closure experienced decreases in outpatient and emergency department (ED) utilization and no statistically significant changes in total medical spending relative to the unaffected individuals. Outpatient and ED utilization decreased by 0.133 (
Source: Medical Care - Category: Health Management Tags: Original Articles Source Type: research