15 Aug Comptroller: Rural counties have ‘alarming shortfalls’ of health professionals

Comptroller DiNapoli Releases Report On Shortages Of Health Professionals In Rural Areas 

A new report released by State Comptroller DiNapoli earlier this week examined healthcare professional shortages in 16 rural counties in New York state and found alarming shortfalls in primary care, pediatric, and obstetrician and gynecologist (OBGYN) doctors, dentists and mental health practitioners, with several counties having no pediatricians or OBGYN doctors at all. The shortage of mental health practitioners in New York’s rural counties may be the most severe, with all counties designated by the federal government as areas having professional shortages.

The rural counties examined 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,” DiNapoli said. “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.”

Please find below a summary of the report:

•  The report examines 16 counties with just under 750,000 people, around 3.8% of New York’s population, but over 37 percent of its land area.
  • 27% of this population were enrolled in Medicaid as of May 2025
  •  Enactment of HR1 will greatly impact rural hospitals: 6 rural hospitals in NYS are in the top 10% for Medicaid payer mix in the country
•  They found low rates of health care providers and an alarming lack of access to basic care in many counties
  •  Specific to primary care:
  •  On average, the 16 rural counties examined in this report have 4 primary care physicians per 10,000 people – a ratio that is less than half that of the state (8.1) and the U.S. (8.4) and falls below the GMENAC guideline (6.9).
  •  For the nearly 173,000 people in Primary Care Health Professional Shortage Areas (HPSAs) who are underserved (23% of these rural counties’ populations), these shortages are more severe (as low as 0.12 physicians per 10,000 people)
  • All 16 counties are designated as Primary Care HPSAs except Essex
•  Physician Assistant and Nurse Practitioner ratios:
  •  PAs – 4.2 per 10,000 (as compared to NYS: 9.2)
  • NPs – 10.5 per 10,000 (as compared to NYS: 16.4)
• Their recommendations include:

1.  Bring more healthcare to people by identifying ways to open new healthcare offices and facilities, which could also include creating mobile clinics and school-based health centers.

2.   Enhancing and expanding ways to bring people to existing care, including expanded and multi-county paratransit, transportation vouchers where private transportation companies exist, and expanding opportunities for telemedicine.

3.  Pursuing policies to bolster the rural healthcare workforce. One policy to consider would be incentivizing the training of new healthcare professionals to serve in rural New York through loan forgiveness programs and rural stipends/subsidies for salaries and attracting existing professionals to rural areas through similar programs or implement reciprocity programs for out-of-state professionals to serve in rural areas.

Other findings that may be of interest:

• Pediatrics:
  • Rural counties have only 0.5 pediatricians per 10,000 people (vs. NYS: 2.8)
  • Three counties have no pediatricians
•  Obstetrics/Gynecology:
  • The average ratio is 0.4 Ob/Gyns per 10,000
  • Four counties have no Ob/Gyns at all
• Dentists:
  • Average ratio is 3.6 per 10,000, less than half of NYS (8.3)
  • Hamilton County has no dentists
• Mental Health Providers:
  • Rural ratio: 6.9 per 10,000, less than half of NYS (16.1)
  • All 16 counties are designated as Mental Health HPSAs

To view the press release and full report please click here.