New Report Shows Rural Hospitals Harmed by Medicare Advantage

75% of rural hospital leaders say Medicare Advantage is their most challenging payer

February 16, 2025 (Sandy Springs, GA.) – Rural hospitals are fighting for their survival, and their leaders are speaking out. A new report from healthcare research firm Write-Off Warrior captures firsthand accounts of how corporate insurance policies are pushing these hospitals to the brink of closure.

The study, Preyed On: How Insurance Corporations Are Bleeding Rural Hospitals and Communities to Death, surveyed 41 rural hospital CEOs across the United States and discovered grave challenges faced by community hospitals. Key findings include:

• 75% of rural hospital leaders said their most difficult insurance payer is Medicare Advantage–the federal program that funnels U.S. taxpayer money earmarked for seniors and disabled Americans through private insurance plans.
• Insurance companies routinely refuse to approve medical procedures, delay payments, and deny reimbursements altogether, straining hospital operations.
• Payer policies are directly hurting patient care, forcing hospitals to cut essential services like obstetrics, mental health, and rehabilitation.
• Inflation and rising costs are compounding financial pressures on rural hospitals.

Rural CEOs Share Their Stories

The Preyed On report includes firsthand accounts from rural hospital CEOs, giving them a platform to describe the impact of insurance policies on their hospitals, communities, and patients. Many fear they will soon join the 700+ rural hospitals already at risk of closure due to financial instability. Among the CEOs profiled in the report is Mark Burket, head of Platte Health Center Avera in South Dakota. “We are that safety net – above and beyond even healthcare services – to rural communities,” Burket says in the report. “That safety net is threatened.”

"Rural hospitals are the lifeline of their communities, yet Medicare Advantage is squeezing them to the brink of collapse," said Mark Craig, CEO of Write-Off Warrior and lead author of the Preyed-On report.

The report, which includes policy recommendations for protecting rural hospitals, is available for download here new report