Rural Health
Resources by Topic: Critical Access Hospitals
The Pennsylvania Rural Health Model (PARHM): Fourth Annual Evaluation Report
Evaluates the fourth performance year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall healthcare spending. Provides an overview of the model and describes the implementation experience of participating hospitals and payers. Presents a descriptive quantitative assessment of financial performance, spending and utilization, access to care, and quality of care outcomes from 2016, the model's baseline, through 2022. Includes three case studies discussing three themes: experiences with global budget reconciliation, behavioral health transformation, and interactions and alignment between PARHM and other value-based care programs.
Additional links: Appendix, Findings at a Glance
Date: 12/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Evaluates the fourth performance year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall healthcare spending. Provides an overview of the model and describes the implementation experience of participating hospitals and payers. Presents a descriptive quantitative assessment of financial performance, spending and utilization, access to care, and quality of care outcomes from 2016, the model's baseline, through 2022. Includes three case studies discussing three themes: experiences with global budget reconciliation, behavioral health transformation, and interactions and alignment between PARHM and other value-based care programs.
Additional links: Appendix, Findings at a Glance
Date: 12/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Hospital Margins Rebounded in 2023, But Rural Hospitals and Those With High Medicaid Shares Were Struggling More Than Others
Examines hospital margins for non-federal general short-term hospitals in the U.S. from 2018 through 2023, with a focus on operating margins. Analyzes RAND Hospital Data to explore the extent to which hospitals profited or lost money on patient care and other operating activities. Discusses differences in operating margins by hospital characteristics, including hospital ownership type, commercial share, size, rural or urban location, and Medicare rural payment designation.
Date: 12/2024
Type: Document
Sponsoring organization: KFF
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Examines hospital margins for non-federal general short-term hospitals in the U.S. from 2018 through 2023, with a focus on operating margins. Analyzes RAND Hospital Data to explore the extent to which hospitals profited or lost money on patient care and other operating activities. Discusses differences in operating margins by hospital characteristics, including hospital ownership type, commercial share, size, rural or urban location, and Medicare rural payment designation.
Date: 12/2024
Type: Document
Sponsoring organization: KFF
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Critical Access Hospital Financial Sustainability Guide
Provides guidance and assistance to state Medicare Rural Hospital Flexibility (Flex) Program personnel, leaders of Critical Access Hospitals (CAHs), and others helping CAHs manage long-term financial stability. Presents potential interventions CAHs may use to address ongoing and systemic financial challenges in rural healthcare.
Date: 12/2024
Type: Document
Sponsoring organizations: EideBailly, National Rural Health Resource Center
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Provides guidance and assistance to state Medicare Rural Hospital Flexibility (Flex) Program personnel, leaders of Critical Access Hospitals (CAHs), and others helping CAHs manage long-term financial stability. Presents potential interventions CAHs may use to address ongoing and systemic financial challenges in rural healthcare.
Date: 12/2024
Type: Document
Sponsoring organizations: EideBailly, National Rural Health Resource Center
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Strategies for Critical Access Hospitals to Address Outmigration
Provides an overview of factors that may contribute to a rural healthcare facility experiencing bypass or market share loss. Offers strategies to help rural hospitals, Critical Access Hospitals (CAHs), and Rural Health Clinics (RHCs) increase Primary Service Area (PSA) market share and address outmigration.
Date: 12/2024
Type: Document
Sponsoring organizations: Impact! Communications, Inc., National Rural Health Resource Center
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Provides an overview of factors that may contribute to a rural healthcare facility experiencing bypass or market share loss. Offers strategies to help rural hospitals, Critical Access Hospitals (CAHs), and Rural Health Clinics (RHCs) increase Primary Service Area (PSA) market share and address outmigration.
Date: 12/2024
Type: Document
Sponsoring organizations: Impact! Communications, Inc., National Rural Health Resource Center
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CY 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1809-FC)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; incorporating an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 11/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; incorporating an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 11/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Texas Rural Hospital Services Strategic Plan Progress Report, 2024
Reports on the progress, strategies, and milestones of the Texas Rural Hospital Services Strategic Plan. Discusses strategies to support rural hospitals, covering policies and initiatives related to Medicaid reimbursements, hospital revenue opportunities, challenges providing care to patients covered by Medicare and other payers, use of state funds for hospital stabilization, and infrastructure development. Provides a map of rural hospitals, Critical Access Hospitals, and Rural Emergency Hospitals in Texas.
Date: 11/2024
Type: Document
Sponsoring organization: Texas Health and Human Services
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Reports on the progress, strategies, and milestones of the Texas Rural Hospital Services Strategic Plan. Discusses strategies to support rural hospitals, covering policies and initiatives related to Medicaid reimbursements, hospital revenue opportunities, challenges providing care to patients covered by Medicare and other payers, use of state funds for hospital stabilization, and infrastructure development. Provides a map of rural hospitals, Critical Access Hospitals, and Rural Emergency Hospitals in Texas.
Date: 11/2024
Type: Document
Sponsoring organization: Texas Health and Human Services
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Critical Access Hospital: 2025 National Patient Safety Goals
Identifies National Patient Safety Goals for the Joint Commission's Critical Access Hospital Accreditation Program. Covers patient identification, caregiver communication, medication safety, infection prevention, suicide prevention, healthcare equity, and more. Effective January 1, 2025.
Date: 10/2024
Type: Document
Sponsoring organization: Joint Commission
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Identifies National Patient Safety Goals for the Joint Commission's Critical Access Hospital Accreditation Program. Covers patient identification, caregiver communication, medication safety, infection prevention, suicide prevention, healthcare equity, and more. Effective January 1, 2025.
Date: 10/2024
Type: Document
Sponsoring organization: Joint Commission
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CAH Perspectives on Collection and Use of Demographic and Social Drivers of Health Data
Describes how collecting information about social drivers of health (SDOH) can help hospitals inform treatment and discharge planning decisions and identify local health disparities. Summarizes findings from interviews with nine Critical Access Hospital (CAH) staff regarding their experiences collecting demographic and SDOH data. Highlights themes related to challenges CAH staff face in collecting this data and how CAHs utilize the data they collect.
Author(s): Madeleine Pick, Carson Crane, Megan Lahr
Date: 10/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
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Describes how collecting information about social drivers of health (SDOH) can help hospitals inform treatment and discharge planning decisions and identify local health disparities. Summarizes findings from interviews with nine Critical Access Hospital (CAH) staff regarding their experiences collecting demographic and SDOH data. Highlights themes related to challenges CAH staff face in collecting this data and how CAHs utilize the data they collect.
Author(s): Madeleine Pick, Carson Crane, Megan Lahr
Date: 10/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
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Frontier Community Health Integration Project (FCHIP) Demonstration Extension Fact Sheet
Provides an overview of the Frontier Community Health Integration Project (FCHIP) Demonstration Extension, which tests new healthcare delivery models in the most sparsely populated rural counties. Identifies participating Critical Access Hospitals and models tested.
Date: 10/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the Frontier Community Health Integration Project (FCHIP) Demonstration Extension, which tests new healthcare delivery models in the most sparsely populated rural counties. Identifies participating Critical Access Hospitals and models tested.
Date: 10/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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The Rural Emergency Hospital Model: Year Two Progress Report
Provides an overview of the Rural Emergency Hospital (REH) payment designation, including the growth in REHs through September 1, 2024, factors that contribute to a hospital seeking REH conversion, and the impacts of REH conversion. Outlines concerns identified by REH leaders, facilities considering converting to REH status, and other rural stakeholders related to the REH designation, as well as policy recommendations to address these concerns.
Author(s): Emma Sheffert, Julia Harris, Marilyn Werber Serafini
Date: 10/2024
Type: Document
Sponsoring organization: Bipartisan Policy Center
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Provides an overview of the Rural Emergency Hospital (REH) payment designation, including the growth in REHs through September 1, 2024, factors that contribute to a hospital seeking REH conversion, and the impacts of REH conversion. Outlines concerns identified by REH leaders, facilities considering converting to REH status, and other rural stakeholders related to the REH designation, as well as policy recommendations to address these concerns.
Author(s): Emma Sheffert, Julia Harris, Marilyn Werber Serafini
Date: 10/2024
Type: Document
Sponsoring organization: Bipartisan Policy Center
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