Will rural hospitals survive 2026?

As 2026 begins, medical practices are facing a risk environment that is broader, more interconnected and more relentless than at any point in recent memory. Once-isolated threats have begun to overlap, amplifying pressure on physicians, administrators and health systems already stretched thin.

Burnout and mental strain remain persistent undercurrents. Staffing shortages, rising patient complexity, administrative burden and financial uncertainty continue to erode morale across care settings. For many clinicians, stress is no longer episodic but structural, shaping daily decision-making and long-term career choices. The human cost of this strain increasingly intersects with operational and legal risk for practices themselves.

At the same time, cyber threats have become a routine hazard of modern health care. Medical practices now sit on vast stores of sensitive data while relying on interconnected digital systems that were never designed with today’s threat landscape in mind. Ransomware attacks, data breaches and system disruptions are no longer rare events, and their consequences extend far beyond IT departments, affecting patient safety, regulatory exposure and financial stability.

Financial and operational risks are especially acute for rural hospitals and independent practices. Declining reimbursement, aging infrastructure, and limited access to capital have left many facilities operating on thin margins. Closures and service reductions continue to reshape access to care in large parts of the country, with ripple effects for surrounding providers and communities.

Legal exposure is another growing concern. Malpractice costs remain high, and the complexity of care delivery, documentation requirements and patient expectations continues to evolve. For many practices, liability risk is no longer confined to clinical decisions alone but tied to systems, staffing and communication failures.

Taken together, these pressures define a risk landscape that is not theoretical or distant, but immediate and personal for medical practices in 2026.

Medical Economics spoke with Peter Reilly, M.S., North American healthcare practice leader and chief sales officer at HUB International, about these risks and what’s driving them. In this episode, Reilly discusses the risks associated with rural hospitals.