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Rural Health
Resources by Topic: Healthcare facilities

Financial Performance Gaps Between Critical Access Hospitals and Other Acute Care Hospitals
Research letter examining how system affiliation impacted hospital financial measures for Critical Access Hospitals (CAHs) and non-CAHs between 2020 and 2022.
Author(s): Christopher Whaley, Marilyn Bartlett, Ge Bai
Citation: JAMA Health Forum, 5(12)
Date: 12/2024
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Medicare Could save Billions with Comparable Access for Enrollees If Critical Access Hospital Payments for Swing-Bed Services Were Similar to Those of the Fee-for-Service Prospective Payment System
Describes the use of swing beds for skilled nursing services at Critical Access Hospitals (CAHs) and average daily Medicare reimbursement for these services from 2015 through 2020. Examines data from a sample of 100 CAHs to determine whether Medicare enrollees would have had access to the same skilled nursing services provided by CAHs at alternative facilities within a 35-mile driving distance. Compares the average daily reimbursement for skilled nursing services at CAHs and alternative facilities, as well as the potential savings to Medicare if CAHs were reimbursed for skilled nursing services under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS).
Date: 12/2024
Sponsoring organization: Office of Inspector General (HHS)
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Associations Between Rural Hospital Closures and Acute and Post-Acute Care Access and Outcomes
Examines the impact of rural hospital closures on hospital and post-acute care (PAC) use and outcomes. Analyzes 32 rural hospital closures and county-level impacts on travel distances, lengths of stay at hospitals, hospital charges, PAC episodes, fall injuries and related mortality and hospitalizations, and population-level hospitalization and death rates. Includes descriptive statistics of 2014-2018 rural hospital closure status.
Author(s): Geoffrey J. Hoffman, Jinkyung Ha, Zhaohui Fan, Jun Li
Citation: Health Services Research
Date: 12/2024
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Mapping Geographic Access to Illinois Birthing Hospitals, 2016–2023
Examines geographic access to birthing hospitals between 2016 to 2023 for women of reproductive age in Illinois. Includes maps showing driving times to hospitals and closed hospitals in the state, as well as changing levels of access for rural and urban women.
Author(s): Barbara C. Keino, Mechelle D. Claridy, Laurin Kasehagen, et al.
Citation: Preventing Chronic Disease, 21
Date: 12/2024
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Suicide Care in Kentucky Hospitals
Provides an overview of suicide-related visits in Kentucky hospitals and emergency departments, recent changes, and patient demographics. Features statistics including percentages of suicide-related visits in 2017-2023 in rural and urban Kentucky hospitals, and a county-level map showing locations of psychiatric hospitals.
Date: 12/2024
Sponsoring organization: Kentucky Hospital Association
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December 2024 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2024 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, Rural Emergency Hospitals (REHs), skilled nursing facility services, inpatient rehabilitation facility services, home health services, hospice services, and outpatient dialysis services.
Additional links: Assessing Payment Adequacy and Updating Payments: Hospital Inpatient and Outpatient Services; and Mandated Report on Rural Emergency Hospitals - Presentation Slides, Assessing Payment Adequacy and Updating Payments: Skilled Nursing Facility Services - Presentation Slides
Date: 12/2024
Sponsoring organization: Medicare Payment Advisory Commission
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How Community Health Centers Respond to Rural Hospital Closures
Describes how community health centers work to fill gaps in healthcare services and impact the economy when a local rural hospital closes.
Author(s): Nick Widmyer, Lena Ben-Gideon
Date: 12/2024
Sponsoring organization: National Association of Community Health Centers
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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
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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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
Sponsoring organization: KFF
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Use of Inpatient Psychiatric Facilities by Medicare Beneficiaries with Dementia
Describes the sociodemographic and health characteristics of Medicare beneficiaries with and without dementia who use inpatient psychiatric facilities (IPFs). Examines diagnoses and utilization that precede psychiatric inpatient stays and outcomes following IPF stays, including health care utilization and mortality. Includes data on Medicare IPF patients who reside in rural counties and counties that are entirely or partially in a primary care or mental health Health Professional Shortage Area (HPSA).
Author(s): Mark Sorbero, Flora Sheng, Swad Komanduri, Jodi L. Liu
Date: 12/2024
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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