Rural Hospital Ownership: Medical Service Provision, Market Mix, and Spillover Effects

Roughly one half of hospitals in the U.S. are in rural areas, yet researchers have largely studied the effects of hospital ownership in the urban context. We examine differences in the provision of profitable and unprofitable medical services in rural areas across nonprofit, for-profit, and government hospitals. We also consider the effect of hospital ownership mix within rural hospital markets. We find that rural nonprofit hospitals are more likely than for-profit hospitals to offer unprofitable services, many of which are underprovided services. Nonprofits respond less than for-profits to changes in service profitability. Nonprofits with more for-profit competitors offer more profitable services and fewer unprofitable services than those with fewer for-profit competitors.