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Rural Health
Resources by Topic: Critical Access Hospitals

Calculation of Overall Hospital Quality Star Ratings With and Without Inclusion of the Peer Grouping Step
Examines potential implications of including a peer grouping step in the calculation of Centers for Medicare & Medicaid Services (CMS) Overall Star Ratings. Uses January 2023 Medicare Care Compare data on 3,076 hospitals that received a star rating to calculate the peer groups based on the number of quality measure groups for which hospitals had 3 or more reported measures. Presents data on the characteristics of each peer group, the distribution of star ratings whether the peer grouping step was used or not used, and the number of hospitals with a higher, lower, or identical star rating when the peer grouping step was applied. Compares data by hospital characteristics, including safety-net status, Critical Access Hospital status, rural or urban location, and more.
Author(s): Cameron J. Gettel, Kyle Bagshaw, Li Qin, et al.
Citation: JAMA Network Open, 7(5), e2411933
Date: 05/2024
Type: Document
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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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Differences in Measurement of Operating Margin: An Update
Describes how differences in measurement of operating margin for hospitals can affect the reported values. Compares the operating margins of urban and rural prospective payment system hospitals and Critical Access Hospitals (CAHs) across three definitions of operating margin using Medicare Cost Report data from April 2021 through March 2022. Describes situations in which each operating margin would be the most appropriate to calculate. Updates a 2008 study from the Flex Monitoring Team.
Author(s): Jessie Ma, Susie Gurzenda, Kristin Reiter, George Pink
Date: 05/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Markup of H.R. 8261, H.R. 7931, H.R. 8245, H.R. 8244, H.R. 8235, and H.R. 8246
Recording of a May 8, 2024, House Ways and Means Committee markup of six bills regarding rural health. Legislation covers the extension of telehealth flexibilities, location requirements for Critical Access Hospitals in mountainous areas, the rural nursing home and physician workforce, and Rural Emergency Hospital eligibility.
Date: 05/2024
Type: Video/Multimedia
Sponsoring organization: House Ways and Means Committee
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US Hospital Service Availability and New 340B Program Participation
Examines whether participation in the 340B Drug Pricing Program was associated with investment in hospital-based services among newly participating hospitals between 2012 and 2018. Compares the provision of profitable and unprofitable services between 1,074 hospitals newly participating in the 340B program and 1,078 hospitals that never participated in the program by hospital characteristics, including hospital ownership, rural versus urban location, community social vulnerability index, and Critical Access Hospital (CAH) status.
Author(s): Kelsey M. Owsley, Romana Hasnain-Wynia, Ronica N. Rooks, et al.
Citation: JAMA Health Forum, 5(5), e240833
Date: 05/2024
Type: Document
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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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"Economic Development is Population Health": A New Vision for Rural Hospital Leadership
Describes the role that rural hospital investments can play in contributing to community health. Features a Wisconsin Critical Access Hospital making infrastructure investments in their downtown and a New Hampshire medical center investing in public transit and affordable housing.
Author(s): Brendan Stermer
Citation: Rural Monitor
Date: 04/2024
Type: Document
Sponsoring organization: Rural Health Information Hub
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Meeting Essential Health Services And Reimagining Obstetrics In A Rural Community
Case study profiling Kittitas Valley Healthcare (KVH) in rural Washington. Describes how KVH implemented a new staffing model to maintain essential obstetrics and gynecological care.
Date: 04/2024
Type: Document
Sponsoring organization: American Hospital Association
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2023 National CAH Quality Inventory & Assessment National Report
Presents a high-level summary of key data points from the October-December 2023 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; and CAH quality payment model participation.
Author(s): Megan Lahr, Robert Barclay, Madeleine Pick
Date: 04/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
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Medicare Payment for Rural or Geographically Isolated Hospitals
Displays data on Medicare payment adjustments for Sole Community Hospitals, Medicare-Dependent Hospitals, Low-Volume Hospitals, and Critical Access Hospitals. Includes information on the number of qualifying hospitals by state and eligibility criteria.
Date: 04/2024
Type: Document
Sponsoring organization: Congressional Research Service
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