A report from New York State Comptroller Thomas P. DiNapoli has found significant shortages of healthcare professionals in 16 rural counties across the state. The study highlights a lack of primary care, pediatric, and obstetrician-gynecologist (OBGYN) doctors, as well as dentists and mental health practitioners. In some counties, there are no pediatricians or OBGYNs at all.
The counties included in the analysis were Allegany, Cattaraugus, Chenango, Delaware, Essex, Franklin, Greene, Hamilton, Herkimer, Lewis, Schuyler, Steuben, Sullivan, Washington, Wyoming and Yates.
“Having access to health care is an essential quality of life issue and helps people live healthier lives,” said DiNapoli. “Addressing gaps in the rural healthcare workforce to alleviate current shortages and plan for future demand will not only positively impact the health of people living in less populated areas of New York, but could also create new jobs and bolster our rural economies.”
The report points out that limited numbers of providers and facilities make it harder to recruit more healthcare workers. Not every county has a hospital or rural health clinic; those that do often operate with tight budgets or financial losses. Recent changes to Medicaid eligibility under Public Law No: 119-21 may worsen these problems by potentially forcing some rural hospitals to close. Six rural hospitals in New York are among the top ten percent nationwide for Medicaid payer mix; five others have posted negative margins for three straight years. As of May 2025, about 27% of residents—204,899 people—in these counties were enrolled in Medicaid.
It remains uncertain whether funding from the federal Rural Hospital Transformation Program will be enough to counteract Medicaid cuts. The law provides $10 billion annually from fiscal years 2026 through 2030 for rural hospitals and clinics nationwide; however, there is no guarantee all states applying will receive funds.
Transportation challenges further complicate access to healthcare services for residents without cars. While public transportation options are limited in most rural counties, paratransit services for older adults are common and could potentially be expanded to other groups lacking transportation options.
Telemedicine has been identified as one way to improve access but cannot replace all types of care since physical exams and certain tests require patients’ presence at medical facilities. However, telemedicine may help increase access to mental health counseling providers.
Other suggested approaches include deploying mobile clinics on regular schedules in underserved communities instead of building permanent facilities. School-based health centers could also help expand care options for children in these areas.
The report suggests that policies such as loan forgiveness programs or stipends could encourage new or existing professionals to practice in rural New York. Reciprocity programs might also allow out-of-state practitioners to serve these communities more easily.
Further information can be found in related reports on topics like broadband challenges affecting access (“Availability, Access and Affordability: Understanding Broadband Challenges in New York State”) and maternal health audits (“Audit: Maternal Health”).
