Heart failure care should not depend on your ZIP code. I’m proud to co-author HF STATS 2026 from the @HFSA, published in @JCardFail, and to have drafted the updated section on hospitalizations alongside an outstanding writing group led by @EiranGorodeski Three findings I’m highlighting: • The burden is growing: an estimated 7.7 million U.S. adults have heart failure, projected to reach 11.4 million by 2050. • Hospitalizations remain staggering: in 2023, there were approximately 1.27 million U.S. hospitalizations with HF as the primary diagnosis, and more than 6 million with HF as either a primary or secondary diagnosis. • This is not just a disease of older adults: HF hospitalization rates among adults younger than 65 increased from 124 to 161 per 100,000 between 2010 and 2022, even as rates declined among older adults. The regional disparities hit especially close to home. In 2023, age-standardized HF prevalence among Medicare fee-for-service beneficiaries was 15% in Oklahoma and 14% in Arkansas—among the highest in the country. The rural findings also demand careful interpretation. Patients in rural settings had fewer cardiology visits after discharge and a lower likelihood of achieving optimal guideline-directed medical therapy. Declining rural hospitalization rates do not mean better outcomes: hospital closures, fewer available beds, and longer travel distances may contribute to fewer admissions. For us at @MidAmericaHeart and @saintlukeskc this is a shared regional responsibility. Communities in neighboring Oklahoma and Arkansas are part of the broader region we support. We must continue strengthening partnerships with rural clinicians, improving timely follow-up and medication access, and bringing specialty expertise closer to patients’ homes. Our goal is fewer preventable hospitalizations because patients are receiving better care, not fewer admissions because care is harder to reach. doi.org/10.1016/j.cardfail.2…