It seems rural/small town hospitals/clinics have been closing for years.
This apocalypse is happening throughout rural communities across the country. More than 100 rural hospitals have closed in the past decade, according to the Center for Healthcare Quality and Payment Reform (CHQPR), a national policy center that works to improve health care payment systems and whose data have been cited by the Bipartisan Policy Center. About one-third of all rural hospitals in the country are at risk of closing because of financial problems.
If you read the Time article private can get away by underpaying small hospitals.
Larger hospitals have more leverage to negotiate with private insurers