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Rural Health
Resources by Topic: Critical Access Hospitals

Understanding CMS' Changes to Hospital Overall Star Ratings
Summarizes an analysis of the effects of methodological changes to the Centers for Medicare & Medicaid Services (CMS) star ratings system. Compares hospital star ratings in 2020 and 2021 and examines differences in ratings by hospital characteristics. Explores the equitability of the ratings by peer groups. Highlights challenges to comparing the ratings of small hospitals and Critical Access Hospitals. Provides recommendations for CMS to improve the equity of the star ratings.
Date: 07/2022
Sponsoring organization: American Hospital Association
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Report to Congress: Unified Payment for Medicare-Covered Post-Acute Care
Presents a prototype for a Unified Post-acute Care (PAC) prospective payment system (PPS) that would set payment for PAC services on the basis of the clinical characteristics of the patient rather than the type of provider. Details the structure of the prototype and the data used in the analyses to design and calibrate the PPS. Explores key considerations for unifying PAC payment, such as cost-sharing and value-based payment. Includes data on PAC provider characteristics, including facility size and rural status, as well as rural payment adjustments.
Additional links: Appendices
Author(s): Benjamin Silver, Anne Deutsch, Nicole Coomer, et al.
Date: 07/2022
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Texas State Office of Rural Health: Supporting CAHs and RHCs to Create Tangible Change in Rural Texas Communities
Provides an overview of a conversation between Rural Healthcare Provider and Transition Project (RHPTP) and Texas State Office of Rural Health (SORH) staff about value-based care (VBC) to support rural hospitals and clinics. Highlights the process of Sudan Medical Clinic moving toward VBC and collaborating with the RHPTP, as well as the opportunities for communication between SORHs and rural healthcare facilities around the state.
Date: 07/2022
Sponsoring organization: National Rural Health Resource Center
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Co-located Critical Access & Behavioral Health Hospital: Charles A. Cannon Jr. Memorial Hospital and Appalachian Regional Behavioral Hospital
Profiles Charles A. Cannon, Jr. Memorial Hospital, a Critical Access Hospital (CAH), and Appalachian Regional Healthcare System (ARHS) in western North Carolina. Describes how ARHS secured an exemption from the Center for Medicare & Medicaid Services (CMS) to build Appalachian Regional Behavioral Health (ARBH) Hospital nearby without losing CAH status. Discusses the impact of the CMS exemption on financial sustainability and emergency department wait times.
Date: 07/2022
Sponsoring organization: American Hospital Association
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Barriers and Facilitators Associated With Establishment of Emergency Department-Initiated Buprenorphine for Opioid Use Disorder in Rural Maine
Presents a study on the barriers and facilitators for implementing programs that initiate buprenorphine treatment for patients with opioid use disorder (OUD) seeking care in critical access hospital (CAH) emergency departments (EDs) in rural Maine. Highlights findings of a survey of CAH ED directors on the challenges of implementing buprenorphine initiation programs.
Author(s): Noah K. Rosenberg, Alexander B. Hill, Lily Johnsky, et al.
Citation: Journal of Rural Health, 38(3), 612-619
Date: 06/2022
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The Economic Effects of Rural Hospital Closures
Examines the impact of a rural hospital closure on local economic outcomes. Compares economic changes in nonmetro counties experiencing a hospital closure between 2001 and 2018 to changes in a control group of nonmetro counties. Presents data on the effects of rural hospital closures on annual income, population size, unemployment, and labor force size overall and by closure type and Critical Access Hospital (CAH) and Prospective Payment System (PPS) status.
Author(s): Tyler L. Malone, Arrianna Marie Planey, Laura B. Bozovich, Kristie W. Thompson, George M. Holmes
Citation: Health Services Research, 57(3), 614-623
Date: 06/2022
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Critical Access Hospitals in TX: How Do They Compare to Other TX Hospitals?
Webinar offering an overview of Critical Access Hospitals (CAHs) in Texas. Compares CAHs in Texas with non-CAHs in Texas using multiple variables including size, staffing levels, county characteristics, rurality, and more. See video description for transcript.
Date: 06/2022
Sponsoring organization: University of Texas at Arlington Center for Rural Health and Nursing
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MiCare Champion Cast: How 340B Benefits Rural Michigan
Podcast that explains the 340B drug pricing program and its impact on rural Michigan. Presents a discussion with stakeholders from the Mackinac Straits Health System which includes a Critical Access Hospital, Rural Health Clinic, and other healthcare facilities.
Date: 06/2022
Sponsoring organization: Michigan Health & Hospital Association
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The Pennsylvania Rural Health Model (PARHM): Second Annual Evaluation Report
Evaluates the second 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 during the second performance year.
Additional links: Appendix, Findings at a Glance
Date: 06/2022
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Let's Get a Good Deal on Health Care
Explains the challenges rural hospitals face with current payment systems and the potential that value-based payment holds for meeting rural communities' needs.
Author(s): A. Clinton MacKinney
Citation: Rural Monitor
Date: 05/2022
Sponsoring organization: Rural Health Information Hub
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