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Geographic deserts, provider shortages, and the supply of care — who can reach a clinician, and who cannot.
8 studies on this desk
- Where the uninsured land: coverage at America's community health centers, 2024
66.2% of the 32.4 million patients at America's community health centers were uninsured or on Medicaid in 2024. But the mix flips by state: Texas centers reported 33.6% of patients uninsured against 29.8% on Medicaid; California centers, 10.1% uninsured and 72.0% on Medicaid.
2026-06-15 · 11 min - Where Medicare providers cluster: home health and DME market saturation, 2025
In Los Angeles County, 1,847 home health agencies serve Medicare's fee-for-service population — the most of any U.S. county, at 2.12 per 1,000 beneficiaries, nearly ten times the national rate of 0.22. CMS publishes this market-saturation map for program-integrity monitoring, not as proof of fraud.
2026-06-15 · 10 min - America's care deserts are rural: two-thirds of U.S. health-care shortage areas
Two-thirds of America's active health-care shortage areas are rural: 13,999 of the 21,133 designated Health Professional Shortage Areas — 66.2% — sit in rural communities, against 6,069 non-rural ones. The rural skew holds across primary care (66.0%), mental health (65.3%), and dental health (67.4%) alike, spanning 25,281 federal designations in 60 jurisdictions.
2026-06-14 · 10 min - Medicare Part D drug spending by state: where the dollars concentrate
California prescribers drove $21.26 billion of Medicare Part D drug cost in 2024, the most of any state — followed by New York at $18.17 billion, Florida ($16.84 billion), and Texas ($15.75 billion). The four largest states alone account for nearly a third of the program's $226.74 billion in drug spending.
2026-06-12 · 10 min - Hospice Provider Availability by State: 6,943 Medicare-Certified Providers, 69% For-Profit
6,943 Medicare-certified hospice providers operate across 51 U.S. jurisdictions; 69% are for-profit. California alone holds 31% of all national certifications with an 83% for-profit rate, while New York lists just 40 hospices at 7.5%. Every figure traces to the CMS Care Compare Hospice dataset (yc9t-dgbk) with signed provenance.
2026-06-06 · 10 min - Hospital Price Transparency Enforcement: 11,440 CMS Actions Since 2021
28 civil monetary penalties, 2,993 warning notices, and a complete 5-year federal enforcement record — every action CMS has taken against non-compliant hospitals under the Price Transparency rule. Texas leads with 1,175 enforcement actions; 2025 was the peak year with 5,432 actions. State-level breakdowns and reproducible methodology from CMS data.
2026-06-06 · 10 min - County-Level Nursing-Home RN Staffing Deserts
Across 1,362 U.S. counties with at least three reporting nursing homes, 550 (40%) staff registered nurses below the 0.55 federal hours-per-resident-day floor. A ranked, county-level analysis built on CMS Payroll-Based Journal staffing data — every county traceable to a cryptographically signed snapshot.
2026-06-03 · 12 min - A March spike in Medicare enrollment deactivations thinned provider supply in shortage areas
Medicare enrollment deactivations in PECOS ran 28% above the trailing-twelve-month average in March 2026 — and the spike was not uniform. Deactivations in HRSA-designated shortage areas grew 41% against trend, versus 19% elsewhere. The places least able to absorb a departure lost providers fastest.
2026-04-28 · 6 min
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