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Rural Health
Resources by Topic: Closures of healthcare facilities and services

Rural Health Care: Supporting Lives and Improving Communities
Presents the U.S. Senate Committee on Finance May 16, 2024, hearing on rural healthcare. Discusses the financial vulnerability of rural hospitals, the rural healthcare workforce and graduate medical education (GME), access to maternal healthcare, health information technology and telehealth, and more. Features testimony from the Chartis Center for Rural Health; Grande Ronde Hospital, a Critical Access Hospital in Oregon; the Wisconsin Collaborative for Rural Graduate Medical Education; and the Rural Policy Research Institute.
Additional links: Jeremy P. Davis, Grande Ronde Hospital - Testimony, Keith J. Mueller, Rural Policy Research Institute - Testimony, Lori Rodefeld, Wisconsin Collaborative for Rural Graduate Medical Education - Testimony, Michael Topchik, Chartis Center for Rural Health - Testimony
Date: 05/2024
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Finance
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Using the Updated Financial Distress Index to Describe Relative Risk of Hospital Financial Distress
Describes the relative risk of rural hospitals and selected urban hospitals experiencing financial distress in 2023. Provides an overview of an updated Financial Distress Index (FDI), which incorporates variables reflecting changes to operational environments since the publication of the 2017 FDI to predict and analyze financial distress and risk of rural hospital closure. Presents data on the characteristics of hospitals by relative risk of financial distress in 2023 and the number of hospitals in each state across in category of relative risk of financial distress.
Author(s): Tyler Malone, George Pink, Kristie Thompson, Mark Holmes
Date: 04/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Ten Things to Know About Consolidation in Health Care Provider Markets
Discusses consolidation in healthcare provider markets, including different types of consolidation, trends, benefits and harms for patients and other consumers, key research findings, policy options for increasing competition, and more. Highlights impacts on rural and underserved communities throughout.
Author(s): Zachary Levinson, Jamie Godwin, Scott Hulver, Tricia Neuman
Date: 04/2024
Type: Document
Sponsoring organization: KFF
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MedPAC Report to the Congress: Medicare Payment Policy: Mandated Report: Rural Emergency Hospitals: Chapter 15
Provides an overview of the Rural Emergency Hospital (REH) designation. Discusses the evolution of Medicare's support for rural hospitals through payment policies and the impact of declining inpatient volumes on rural hospitals' financial sustainability. Describes the characteristics of hospitals that converted to REH status in 2023, the first year of the designation.
Date: 03/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Rural Health Research Recap: Post-Acute Care in Rural Areas: The Role of Swing Beds and Nursing Homes
Offers statistics on availability of post-acute care in rural areas through skilled nursing facilities, home health agencies, hospice, inpatient rehabilitation facilities, and swing beds. Includes sections on prospective payment system and cost-based reimbursement, and provides statistics on the proportion of nursing home closures in metropolitan and nonmetropolitan areas from 2008-2018.
Author(s): Per Ostmo
Date: 03/2024
Type: Document
Sponsoring organization: Rural Health Research Gateway
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The Impact of Rural General Hospital Closures on Communities—A Systematic Review of the Literature
Presents a literature review of studies on the health and economic effects hospital closures have had on rural communities. Analyzes 21 studies completed in the previous 8 years and details the economic and healthcare access outcomes identified.
Author(s): Carol A. Mills, Valerie A. Yeager, Kathleen T. Unroe, et al.
Citation: Journal of Rural Health, 40(2), 238-248
Date: 03/2024
Type: Document
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The Rural Nursing Home Landscape
White paper describing the current rural nursing home landscape. Cover the importance of nursing homes in rural communities, the characteristics of these facilities, and the importance of future research to understand and prevent future nursing home closures.
Author(s): Nicole Galler, Casey P. Balio, Qian Huang, Kate Beatty
Date: 02/2024
Type: Document
Sponsoring organization: National Rural Health Association
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Maternal Health in Rural America
White paper describing factors contributing to rural maternal health disparities, including financial barriers to providing obstetric services at rural hospitals, maternal health workforce shortages, access to care, and quality of care. Outlines policy considerations to increase access to maternal health services in rural areas.
Author(s): Hailey Waldman, Alexandra Zimmerman
Date: 02/2024
Type: Document
Sponsoring organization: National Rural Health Association
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Lessons Learned from Efforts to Support Vulnerable Critical Access and Other Rural Hospitals
Provides an overview of state and federal programs, demonstrations, and models designed to support Critical Access Hospitals (CAHs) and other rural hospitals. Describes challenges facing CAHs and rural hospitals, including chronic workforce shortages, high operating and staffing costs, inadequate reimbursement, operational and regulatory issues, and the diverse demographics of rural communities. Discusses lessons learned, the new for a new rural hospital model, and next steps.
Author(s): John Gale, Celia Jewell, Karen Pearson
Date: 02/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
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Unrelenting Pressure Pushes Rural Safety Net Crisis Into Uncharted Territory
Examines financial and operational metrics for rural hospitals. Discusses the growth of Medicare Advantage (MA) enrollment in rural communities between 2019 and 2023, the impact of MA on rural hospital reimbursement, how the Rural Emergency Hospital (REH) designation can provide a path forward for some rural facilities, and the discontinuation of obstetrics and chemotherapy services at rural hospitals since 2011. Includes the percentage of rural hospitals in each state vulnerable to closure and nine factors significantly associated with rural hospital vulnerability.
Date: 02/2024
Type: Document
Sponsoring organization: Chartis Center for Rural Health
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