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Rural Health
Resources by Topic: Critical Access Hospitals

2018‐23 Profitability of Rural and Urban Hospitals by Medicare Payment Designation
Examines the profitability of rural and urban hospitals according to special Medicare payment designations, including: Critical Access Hospitals (CAHs), Prospective Payment System (PPS) hospitals, Medicare Dependent Hospitals (MDHs), Sole Community Hospitals (SCHs), Rural Referral Centers (RRCs), and Essential Access Community Hospitals (EAC). Utilizes 2018-2023 data to analyze hospital profitability by rural versus urban status and facility/payment type.
Author(s): Sruthi Malavika Srinivasan, Kristie Thompson, George Pink
Date: 06/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Rural Health Leaders Overcoming Challenges with Alan Morgan, Kathy Kuepers and Steve Tenhouse
Podcast episode featuring two Critical Access Hospital (CAH) executives discussing factors that influence a rural health organization's growth and vitality, replacement facility projects, and building trust and stakeholder engagement. Also highlights a national partnership addressing rural hospital cybersecurity involving the White House, Google, Microsoft, the American Hospital Association, and the National Rural Health Association.
Date: 06/2024
Type: Audio
Sponsoring organization: Impact! Communications, Inc.
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Interoperable Exchange of Patient Health Information Among U.S. Hospitals: 2023
Presents data on the degree to which hospitals engage in the four domains of interoperable exchange - send, receive, find, and integrate - as of 2023 and describes trends between 2018 and 2023. Analyzes the frequency that non-federal acute care hospitals engaged in interoperable exchange by hospital characteristics, including hospital size, system affiliation status, rural or urban location, and Critical Access Hospital (CAH) designation. Describes hospitals' ability to exchange electronic health information with other providers across the care continuum and how clinicians use this information about the point of care.
Author(s): Meghan Hufstader Gabriel, Chelsea Richwine, Catherine Strawley, Wesley Barker, Jordan Everson
Date: 05/2024
Type: Document
Sponsoring organization: Office of the National Coordinator for Health Information Technology
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Providing Behavioral Health Support for Older Adults
Podcast episode featuring a discussion with leaders of Broaddus Hospital, a Critical Access Hospital in West Virginia, describing how they work to identify and fill the unique mental health needs of older adults in the community, including the development of an intensive outpatient group therapy program for older adults.
Date: 05/2024
Type: Audio
Sponsoring organization: American Hospital Association
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State Requirements for Demographic Data Reporting upon Hospital Discharge: An Overview for State Flex Programs
Summarizes results of an environmental scan of state-level policies regarding current state requirements regarding hospitals' collection and reporting of demographic data among 37 of the 45 states participating in the Medicare Rural Hospital Flexibility (Flex) Program. Describes requirements for sex, gender, and sexual orientation data; race, ethnicity, and language data; and other data and reporting, as well as variations in how categories are defined across states. Discusses challenges Critical Access Hospitals (CAHs) may face in meeting state requirements.
Author(s): Madeleine Pick, Carson Crane, Megan Lahr
Date: 05/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
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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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