Opinion: California’s Rural Hospitals Are in Danger of Closing, But Partnerships with Universities Offer a Solution

By Gary S. May • May 26, 2026

*UC Davis, center, has programs to provide health care to rural communities statewide. Photo by Hal Bergman/iStock.*

Every Californian should have access to quality health care, no matter where they live. But today, that promise is slipping out of reach in rural communities. Without decisive action to support the academic medical centers that offer care and train the next generation of health professionals, the consequences will be felt across the entire state.

The threat to rural hospitals across the state is profound. More than half of California’s rural hospitals operate at a loss, and 13 are at risk of closing. With cuts to Medicaid reimbursement and ACA subsidies, 3 million Californians could face months-long waits for care by 2027.

The recent closure of a medical center in Glenn County eliminated emergency and primary care for a farming community 100 miles north of Sacramento — part of what the Los Angeles Times called a potential “tidal wave” of rural hospital closures. Sadly, when one facility disappears, an entire community can lose its health care overnight.

Over 11 million Californians live in areas the federal government designates as Primary Care Health Professional Shortage areas, meaning they have a shortage of doctors and nurses. Without sustained investment, these gaps will widen, leaving millions with fewer options and longer delays for care.

Academic medical centers are at the heart of ensuring access to this critical care.

Debbie Pease of Chico shows what’s possible when rural cancer care partnerships work. Through the UC Davis Cancer Care Network, she enrolled in a clinical trial for early-stage cancer close to home at Enloe Health Regional Cancer Center, cutting her commute from 90 miles to just one. For patients like Pease, access to nearby clinical trials is essential to bring high-quality cancer care within reach.

The University of California’s six academic health centers train physicians to be the next generation of doctors serving underserved communities. Through the UC Programs in Medical Education (UC PRIME), 40 percent of UC Davis graduates go on to practice in rural areas. They are positioned throughout the state to reach underserved, rural communities.

The UC Davis Family Medicine Residency Network, reaching from Redding to Merced, is also part of the answer. For over half a century, its family medicine residency programs have shared resources and scholarly research statewide. About 85 percent of the graduates from the network practice in California, with over 12 percent serving rural areas.

Protecting rural care must also mean ensuring that California’s native people have access to doctors. The Huwighurruk Tribal Health Postbaccalaureate Program, in partnership with Cal Poly Humboldt, prepares medical students to serve these communities. They learn about the specialized care needs of Tribal communities and participate in research and self-directed clinical activities to prepare them to serve these high-need areas.

Efforts like this demonstrate how targeted training programs can begin to close persistent care gaps in rural regions.

Given their often-remote locations, telehealth services also play an important role in serving rural populations. The UC Davis Medical Center offers virtual real-time connections to over 30 rural hospitals across the state. By bringing adult and pediatric patient care to the bedside, these efforts enable patients to receive treatment close to home, support local rural hospitals, and reduce the need for costly travel.

Now, we must do all we can to protect and strengthen such partnerships. Continued public investment and supportive policy are critical to ensuring academic medical centers can maintain and expand the training, research and partnerships that rural communities depend on.

We encourage ongoing collaboration with our elected officials and community partnerships to expand innovative programs that deliver critical services. The cost of inaction will be measured not only in closed hospitals, but also in more patients left untreated and in communities without reliable care.

Where someone lives should not determine whether they can access care when they need it, but without continued commitment, that is exactly what may happen.