TX · 254 Counties
Texas Rural Health FAQ
Data-driven answers about Texas's 659 hospitals, federal grants, health metrics, and access gaps.
🏥Hospital Access & Infrastructure
How many rural hospitals are in Texas?
Texas has 659 active hospitals across 254 counties, including 92 Critical Access Hospitals and 149 rural-designated facilities. Source: CMS Provider of Services.
How many hospital beds are available in Texas?
Texas's 659 hospitals collectively operate 101,967 beds. Source: CMS Provider of Services.
Which counties in Texas have no hospital?
75 of Texas's 254 counties (30%) 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 Texas?
Of Texas's 659 hospitals, 385 are not-for-profit, 16 are for-profit, and 258 are government-owned. Source: CMS Provider of Services.
How many hospitals have closed in Texas?
25 rural hospitals have closed in Texas since 2005. Source: UNC Sheps Center for Health Services Research.
💰Financial Health
What is the median operating margin for hospitals in Texas?
The median operating margin for Texas's hospitals is 1.3% as of FY2025. 62 hospitals are operating at a loss. Source: CMS Healthcare Cost Report Information System (HCRIS).
How many hospitals in Texas have negative operating margins?
62 of Texas'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 Texas?
The average occupancy rate across Texas's hospitals is 52.9% 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 Texas?
Texas receives 19 active HRSA grants totaling $33.0M in FY2025. Programs include Rural Health Outreach ($14.1M), Small Hospital Improvement (SHIP) ($10.4M), Flex Program ($6.9M), State Office of Rural Health ($1.5M). Source: USAspending.gov.
What is the Rural Health Care Services Outreach program in Texas?
Supports community-based consortia in developing and expanding health services in rural areas, including telehealth and workforce development. In Texas, this program (CFDA 93.912) provides $14.1M across 16 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 Texas?
Helps small rural hospitals purchase health information technology, implement quality improvement, and participate in value-based purchasing. In Texas, this program (CFDA 93.301) provides $10.4M 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 Texas?
Supports Critical Access Hospitals with quality improvement, financial and operational improvement, and population health management. In Texas, this program (CFDA 93.241) provides $6.9M 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 Texas?
Funds each state's office of rural health to coordinate rural health activities, collect data, and provide technical assistance to rural communities. In Texas, 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 Texas?
The largest rural health grant recipients in Texas are: Agriculture, Texas Department Of ($18.8M); Bexar County Hospital District ($2.8M); Texas A & M University System Health Science Center ($2.5M); The University Of Texas Health Science Center At San Antonio ($2.0M); Lubbock County Hospital District ($1.5M). Source: USAspending.gov, FY2025.
🎯AHEAD & RHT Transformation
How much RHT Transformation funding did Texas receive?
Texas receives $281.3M/year under the CMS Rural Health Transformation Program (CFDA 93.798) for FY2026–2030 — approximately $1.4B over the full five-year period. The lead agency is Health & Human Svc Commn Tx. Source: USAspending.gov.
Who manages the RHT Transformation award in Texas?
Health & Human Svc Commn Tx is the designated lead agency managing Texas's $281.3M/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 Texas?
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. Texas's $281.3M/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 Texas's counties?
Across Texas's 254 counties, the average diabetes rate is 13.4%, obesity rate is 39.3%, and uninsured rate is 19.8%. There are 4.5 primary care physicians per 10,000 residents on average (2025). Source: County Health Rankings.
How vulnerable are Texas's communities?
Texas has 131 high-vulnerability counties based on CDC Social Vulnerability Index scores, with a statewide average SVI of 0.71 (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 Texas?
Texas has 1261 Health Professional Shortage Area (HPSA) designations: 692 in primary care, 223 in dental health, and 346 in mental health. An estimated 30,505,177 people live in underserved areas. Source: HRSA Bureau of Health Workforce.
How many healthcare providers does Texas have?
Texas has 18,563 primary care physicians (60.9/100k population), 33,902 nurse practitioners, 12,714 physician assistants, and 19,776 dentists. Average Medicare per capita cost is $13,585 with a 17.1% readmission rate. Source: AHRF 2024-2025.
What are the key health indicators for Texas at the census tract level?
CDC PLACES data shows Texas's average county-level rates: diabetes 15.1%, obesity 37.7%, depression 22.5%, frequent mental distress 17.5%, smoking 15.2%, and high blood pressure 38.6%. These are derived from census-tract-level BRFSS estimates. Source: CDC PLACES 2023-2024.
How many Federally Qualified Health Centers are in Texas?
Texas has 761 FQHC sites operated by 71 grantee organizations. 194 sites (25.5%) are in rural areas and 567 are in urban areas. FQHCs are a critical safety-net for underserved populations. Source: HRSA GIS Portal.
How many Medically Underserved Areas are in Texas?
Texas has 211 HRSA medically underserved designations: 189 Medically Underserved Areas (MUAs) and 22 Medically Underserved Populations (MUPs). The average MUA score is 53.9 (lower scores indicate greater need). Source: HRSA GIS Portal.
🛠️Tools & Resources
Who can help rural hospitals in Texas 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 Texas?
Federal data on Texas'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 659 hospitals in Texas.
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 Texas Dashboard
Interactive dashboards, AI queries, and hospital risk scoring for Texas's 659 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.