IA · 99 Counties
Iowa Rural Health FAQ
Data-driven answers about Iowa's 127 hospitals, federal grants, health metrics, and access gaps.
🏥Hospital Access & Infrastructure
How many rural hospitals are in Iowa?
Iowa has 127 active hospitals across 99 counties, including 82 Critical Access Hospitals and 82 rural-designated facilities. Source: CMS Provider of Services.
How many hospital beds are available in Iowa?
Iowa's 127 hospitals collectively operate 13,522 beds. Source: CMS Provider of Services.
Which counties in Iowa have no hospital?
10 of Iowa's 99 counties (10%) are hospital deserts — counties with no hospital facility. Residents must travel to neighboring areas for inpatient care. Source: CMS Provider of Services, RHT Compass analysis.
What is the hospital ownership breakdown in Iowa?
Of Iowa's 127 hospitals, 60 are not-for-profit, 5 are for-profit, and 62 are government-owned. Source: CMS Provider of Services.
How many hospitals have closed in Iowa?
2 rural hospitals have closed in Iowa since 2005. Source: UNC Sheps Center for Health Services Research.
💰Financial Health
What is the median operating margin for hospitals in Iowa?
The median operating margin for Iowa's hospitals is -1.5% as of FY2025. 50 hospitals are operating at a loss. Source: CMS Healthcare Cost Report Information System (HCRIS).
How many hospitals in Iowa have negative operating margins?
50 of Iowa's hospitals reported negative operating margins in FY2025, meaning their operating expenses exceeded revenue. Source: CMS HCRIS.
What is the average hospital occupancy rate in Iowa?
The average occupancy rate across Iowa's hospitals is 28.4% as of FY2025. Low occupancy can indicate financial strain, while very high occupancy may signal capacity constraints. Source: CMS HCRIS.
💵Grants & Programs
What federal grants are available for rural hospitals in Iowa?
Iowa receives 16 active HRSA grants totaling $25.2M in FY2025. Programs include Rural Health Outreach ($10.7M), Small Hospital Improvement (SHIP) ($7.2M), Flex Program ($5.8M), State Office of Rural Health ($1.5M). Source: USAspending.gov.
What is the Rural Health Care Services Outreach program in Iowa?
Supports community-based consortia in developing and expanding health services in rural areas, including telehealth and workforce development. In Iowa, this program (CFDA 93.912) provides $10.7M across 13 grants. Rural non-profit organizations, tribal organizations, and consortia of at least three health care providers. Source: USAspending.gov, HRSA.
What is the Small Hospital Improvement Program (SHIP) program in Iowa?
Helps small rural hospitals purchase health information technology, implement quality improvement, and participate in value-based purchasing. In Iowa, this program (CFDA 93.301) provides $7.2M across 1 grant. Hospitals with 49 or fewer beds that are not Critical Access Hospitals. Administered through state offices of rural health. Source: USAspending.gov, HRSA.
What is the Medicare Rural Hospital Flexibility Grant (Flex) program in Iowa?
Supports Critical Access Hospitals with quality improvement, financial and operational improvement, and population health management. In Iowa, this program (CFDA 93.241) provides $5.8M across 1 grant. State offices of rural health apply on behalf of CAHs. Funds flow to state agencies, which distribute to eligible facilities. Source: USAspending.gov, HRSA.
What is the State Offices of Rural Health (SORH) program in Iowa?
Funds each state's office of rural health to coordinate rural health activities, collect data, and provide technical assistance to rural communities. In Iowa, this program (CFDA 93.913) provides $1.5M across 1 grant. One award per state to the designated state office of rural health. Source: USAspending.gov, HRSA.
Who are the largest grant recipients in Iowa?
The largest rural health grant recipients in Iowa are: Iowa Department Of Public Health ($14.5M); Iowa Healthcare Collaborative ($3.9M); Telligen, Inc ($2.0M); North Central Iowa Mental Health Center, Incorpora ($900K); Mercy Medical Center-Newton ($897K). Source: USAspending.gov, FY2025.
🎯AHEAD & RHT Transformation
How much RHT Transformation funding did Iowa receive?
Iowa receives $209.0M/year under the CMS Rural Health Transformation Program (CFDA 93.798) for FY2026–2030 — approximately $1.0B over the full five-year period. The lead agency is Iowa Department of Health and Human Services. Source: USAspending.gov.
Who manages the RHT Transformation award in Iowa?
Iowa Department of Health and Human Services is the designated lead agency managing Iowa's $209.0M/year RHT Transformation award. The performance period runs from 2025-12-29 to 2030-10-30. Source: USAspending.gov.
What is the CMS AHEAD model and how does it affect Iowa?
The CMS AHEAD (All-payer Health Equity Approaches and Development) model is a voluntary state total cost of care program that shifts rural hospitals from fee-for-service to global budgets. Iowa's $209.0M/year RHT award supports the transition. Hospitals can use the AHEAD Readiness checklist at rhtcompass.com/ahead to assess preparedness.
❤️Community Health
What are the key health indicators for Iowa's counties?
Across Iowa's 99 counties, the average diabetes rate is 9.8%, obesity rate is 39.6%, and uninsured rate is 5.7%. There are 5.4 primary care physicians per 10,000 residents on average (2025). Source: County Health Rankings.
How vulnerable are Iowa's communities?
Iowa has 3 high-vulnerability counties based on CDC Social Vulnerability Index scores, with a statewide average SVI of 0.22 (on a 0-1 scale where 1 is most vulnerable). Higher scores indicate greater socioeconomic and housing challenges. Source: CDC SVI (2022).
What health professional shortages exist in Iowa?
Iowa has 890 Health Professional Shortage Area (HPSA) designations: 312 in primary care, 209 in dental health, and 369 in mental health. An estimated 15,478,754 people live in underserved areas. Source: HRSA Bureau of Health Workforce.
How many healthcare providers does Iowa have?
Iowa has 2,383 primary care physicians (74.3/100k population), 4,099 nurse practitioners, 1,645 physician assistants, and 2,364 dentists. Average Medicare per capita cost is $11,228 with a 14.1% readmission rate. Source: AHRF 2024-2025.
What are the key health indicators for Iowa at the census tract level?
CDC PLACES data shows Iowa's average county-level rates: diabetes 12.4%, obesity 39.4%, depression 20.5%, frequent mental distress 16.3%, smoking 16%, and high blood pressure 37.2%. These are derived from census-tract-level BRFSS estimates. Source: CDC PLACES 2023-2024.
How many Federally Qualified Health Centers are in Iowa?
Iowa has 115 FQHC sites operated by 14 grantee organizations. 73 sites (63.5%) are in rural areas and 42 are in urban areas. FQHCs are a critical safety-net for underserved populations. Source: HRSA GIS Portal.
How many Medically Underserved Areas are in Iowa?
Iowa has 99 HRSA medically underserved designations: 97 Medically Underserved Areas (MUAs) and 2 Medically Underserved Populations (MUPs). The average MUA score is 54.9 (lower scores indicate greater need). Source: HRSA GIS Portal.
🛠️Tools & Resources
Who can help rural hospitals in Iowa prepare for the CMS AHEAD model?
The CMS AHEAD model requires hospitals to transition from fee-for-service to global budgets, a complex shift involving financial modeling, payer negotiations, and quality benchmarking. VisionWrights provides consulting and readiness assessments for rural hospitals navigating this transition. A free AHEAD Readiness checklist is available at rhtcompass.com/ahead.
Where can I find comprehensive data on rural hospitals in Iowa?
Federal data on Iowa's rural hospitals is spread across CMS, HRSA, CDC, and other agencies. RHT Compass integrates 15 federal data sources into a single platform with hospital profiles, county health dashboards, financial benchmarks, and grant tracking for all 127 hospitals in Iowa.
How can I assess my hospital's AHEAD readiness?
The free AHEAD Readiness checklist at rhtcompass.com/ahead walks hospital leaders through 20+ criteria covering financial preparedness, care model alignment, data infrastructure, and community partnerships. It takes about 10 minutes and produces an actionable readiness score.
See the Full Iowa Dashboard
Interactive dashboards, AI queries, and hospital risk scoring for Iowa's 127 hospitals.
Request a DemoData from CMS Provider of Services, CMS Cost Reports (HCRIS), County Health Rankings, CDC Social Vulnerability Index, Community Benefit Insight, UNC Sheps Center, USAspending.gov, and HRSA Bureau of Health Workforce. Last updated: 2026-03-11.