A recent report from New York State Comptroller Thomas P. DiNapoli has highlighted significant shortages of healthcare professionals in 16 rural counties across the state. The analysis found that these areas face critical gaps in primary care, pediatric, and obstetrician and gynecologist (OBGYN) doctors, as well as dentists and mental health practitioners. Several counties reportedly have no pediatricians or OBGYN doctors at all. Mental health practitioner shortages are especially severe, with every county studied designated by the federal government as having a professional shortage.
The counties examined include 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.”
The report points out that limited numbers of providers and physical facilities present additional challenges for recruiting more healthcare professionals to rural regions. Some counties lack hospitals or rural health clinics entirely; those that exist often operate on narrow margins or even at a loss.
Recent reductions in eligibility for Medicaid and the Essential Plan—resulting from changes included in Public Law No: 119-21—may worsen these challenges by putting further financial strain on local healthcare institutions. Six rural hospitals in New York are among the top ten percent nationally for Medicaid payer mix; five others have posted three consecutive years of negative margins. In total across the 16 counties reviewed, about 204,899 residents—or 27% of their combined population—were enrolled in Medicaid as of May 2025.
It remains uncertain whether funding made available through the federal Rural Hospital Transformation Program will offset losses caused by Medicaid cuts. The law allocates $10 billion annually from fiscal years 2026 to 2030 to support eligible rural hospitals and clinics nationwide; however there is no guarantee all states applying will receive this funding.
Transportation also presents obstacles for accessing healthcare services. Most rural counties have limited public transportation options; however paratransit for seniors is relatively common and could be expanded to serve other populations who lack reliable access to vehicles.
Expanding telemedicine may help address some needs—for example increasing access to mental health counseling—but it cannot fully replace services requiring physical exams or lab work that must be performed in person.
Other possible strategies discussed include deploying mobile clinics on regular schedules within underserved communities and expanding school-based health centers as ways to bring care directly where people live without incurring costs associated with permanent facilities.
The report suggests policy measures such as loan forgiveness programs or stipends targeted at new graduates willing to practice in rural areas—and similar incentives for existing professionals—to attract more workers into these communities. Reciprocity programs allowing out-of-state professionals to serve could also help address staffing gaps.
