Rural Health
Resources by Topic: Hospitals
MedPAC Comment on CMS's Proposed Rule on Inpatient Rehabilitation Facility for FY 2027
Comments on an April 6, 2026, Federal Register proposed rule addressing updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2026. Includes comments on the potential creation of an IRF-specific wage index and refinements to the IRF payment system, such as changes to IRF patient clinical classification. Includes rural considerations throughout.
Date: 04/2026
Sponsoring organization: Medicare Payment Advisory Commission
view details
Comments on an April 6, 2026, Federal Register proposed rule addressing updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2026. Includes comments on the potential creation of an IRF-specific wage index and refinements to the IRF payment system, such as changes to IRF patient clinical classification. Includes rural considerations throughout.
Date: 04/2026
Sponsoring organization: Medicare Payment Advisory Commission
view details
Medicare Payment for Rural or Geographically Isolated Hospitals, 2026
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: 04/2026
Sponsoring organization: Congressional Research Service
view details
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: 04/2026
Sponsoring organization: Congressional Research Service
view details
Payer Mix Shifts and Profitability at Critical Access Hospitals, 2011 to 2023
Analyzes 1,384 Critical Access Hospitals between 2011 and 2023 to determine the impact of changes in commercial, Medicare, Medicaid, and uncompensated care on their finances. Discusses reimbursement policy based on study findings.
Author(s): Yusheng Jia, Yue Li, Xueya Cai, Samuel J. Enumah
Citation: Health Affairs Scholar, 4(4)
Date: 04/2026
view details
Analyzes 1,384 Critical Access Hospitals between 2011 and 2023 to determine the impact of changes in commercial, Medicare, Medicaid, and uncompensated care on their finances. Discusses reimbursement policy based on study findings.
Author(s): Yusheng Jia, Yue Li, Xueya Cai, Samuel J. Enumah
Citation: Health Affairs Scholar, 4(4)
Date: 04/2026
view details
Medicare Wage Index Trends in Rural and Urban Hospitals Before and During the Low Wage Index Policy, 2018–2022
Provides an overview of the wage index and its role in hospital reimbursement and financial stability. Describes the pattern of wage index values for rural and urban prospective payment system (PPS) hospitals from 2018 to 2022. Explores the impact of the low-wage index policy (LWIP), which was implemented in fiscal year 2020, and the potential implications of its discontinuation in fiscal year 2025.
Author(s): Saleema Karim, George Pink, Kristie Thompson, Mark Holmes
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
view details
Provides an overview of the wage index and its role in hospital reimbursement and financial stability. Describes the pattern of wage index values for rural and urban prospective payment system (PPS) hospitals from 2018 to 2022. Explores the impact of the low-wage index policy (LWIP), which was implemented in fiscal year 2020, and the potential implications of its discontinuation in fiscal year 2025.
Author(s): Saleema Karim, George Pink, Kristie Thompson, Mark Holmes
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
view details
Geographic Variation in Average Salary Expense Among Rural Hospitals Nationwide, 2018–2022
Examines the change in hospital wages between 2018–2019 and 2021–2022, with a focus on the geographic variation in these changes among Critical Access Hospitals (CAHs) and rural Prospective Payment System (PPS) hospitals. Describes the variation in average salary expense per full-time equivalent (FTE) employee for rural hospitals from 2018 to 2022. Appendices include the median salary expense per FTE of rural hospitals each year by U.S. Census region, state Medicaid expansion status, Core-Based Statistical Area (CBSA), Frontier and Remote Area (FAR) code, and by state.
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
view details
Examines the change in hospital wages between 2018–2019 and 2021–2022, with a focus on the geographic variation in these changes among Critical Access Hospitals (CAHs) and rural Prospective Payment System (PPS) hospitals. Describes the variation in average salary expense per full-time equivalent (FTE) employee for rural hospitals from 2018 to 2022. Appendices include the median salary expense per FTE of rural hospitals each year by U.S. Census region, state Medicaid expansion status, Core-Based Statistical Area (CBSA), Frontier and Remote Area (FAR) code, and by state.
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
view details
Average Salary Expense in Rural and Urban Hospitals in 2022 Compared with 2018, by Hospital Characteristics
Explores how the COVID-19 pandemic may have affected wage disparities across rural and urban hospitals. Describes the median wages by total employee full-time equivalents (FTE) for rural and urban hospitals from 2017-2018 to 2021-2022. Compares the growth in labor cost for rural and urban hospitals by selected hospital characteristics, including system affiliation, hospital ownership, and number of acute care beds.
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
view details
Explores how the COVID-19 pandemic may have affected wage disparities across rural and urban hospitals. Describes the median wages by total employee full-time equivalents (FTE) for rural and urban hospitals from 2017-2018 to 2021-2022. Compares the growth in labor cost for rural and urban hospitals by selected hospital characteristics, including system affiliation, hospital ownership, and number of acute care beds.
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
view details
Average Salary Expense in Rural and Urban Hospitals Before and During the Low Wage Index Policy, 2018–2022
Examines and compares wage patterns of Critical Access Hospitals (CAHs), Rural Prospective Payment System (PPS) hospitals, and Urban PPS hospitals as related to the Low Wage Index Policy (LWIP) in effect from 2020-2022. Utilizes hospital data from the Centers for Medicare & Medicaid Services (CMS) Healthcare Cost Report Information System (HCRIS) between 2018 and 2022 and analyzes median salaries. Discusses the impact of Medicare payments and LWIP on hospitals.
Author(s): Saleema Karim, George Pink, Kristie Thompson, Mark Holmes
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
view details
Examines and compares wage patterns of Critical Access Hospitals (CAHs), Rural Prospective Payment System (PPS) hospitals, and Urban PPS hospitals as related to the Low Wage Index Policy (LWIP) in effect from 2020-2022. Utilizes hospital data from the Centers for Medicare & Medicaid Services (CMS) Healthcare Cost Report Information System (HCRIS) between 2018 and 2022 and analyzes median salaries. Discusses the impact of Medicare payments and LWIP on hospitals.
Author(s): Saleema Karim, George Pink, Kristie Thompson, Mark Holmes
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
view details
Early Evaluation of the Rural Emergency Hospital Program
Results of a study conducted January 2023 to December 2025, to assess differences between hospitals that converted to Rural Emergency Hospital (REH) status and eligible rural hospitals that did not. Includes statistics on the financial performance of the hospitals before and after conversion, and hospital features and services provided, with breakdowns by REH or non-REH status.
Author(s): Mitchell Mead, Nina M. Clark, Janice C. Probst, et al.
Citation: JAMA Network Open, 9(4), e269217
Date: 04/2026
view details
Results of a study conducted January 2023 to December 2025, to assess differences between hospitals that converted to Rural Emergency Hospital (REH) status and eligible rural hospitals that did not. Includes statistics on the financial performance of the hospitals before and after conversion, and hospital features and services provided, with breakdowns by REH or non-REH status.
Author(s): Mitchell Mead, Nina M. Clark, Janice C. Probst, et al.
Citation: JAMA Network Open, 9(4), e269217
Date: 04/2026
view details
Income and Geographic Disparities in in-Hospital Mortality Following Cardiovascular Procedures: Evidence From the National Inpatient Sample, 2016–2022
Examines in-hospital mortality following cardiovascular procedures as related to income and geographic disparities. Utilizes 2016-2022 National Inpatient Sample data to analyze various cardiovascular procedures and associated mortality risk by income as well as by location of non-metro, metro of 50,000 to 999,000 residents, or metro of 1,000,000 or more residents.
Author(s): Alon Bergman, Ashwin Nathan
Citation: Health Services Research, 61(2), e70117
Date: 04/2026
view details
Examines in-hospital mortality following cardiovascular procedures as related to income and geographic disparities. Utilizes 2016-2022 National Inpatient Sample data to analyze various cardiovascular procedures and associated mortality risk by income as well as by location of non-metro, metro of 50,000 to 999,000 residents, or metro of 1,000,000 or more residents.
Author(s): Alon Bergman, Ashwin Nathan
Citation: Health Services Research, 61(2), e70117
Date: 04/2026
view details
National Trends in the Potentially Preventable Hospitalization for Pediatric Asthma, 2016-2020
Describes the trends in potentially preventable hospitalizations for asthma among children 2 to 17 years old between 2016 and 2020. Presents data on the rate of potentially preventable hospitalizations for pediatric asthma by hospital characteristics and patient demographics, including the rural classification of hospitals and patient residence.
Author(s): Marvellous Akinlotan, Nima Khodakarami, Gogoal Falia, Alva O. Ferdinand
Date: 04/2026
Sponsoring organization: Southwest Rural Health Research Center
view details
Describes the trends in potentially preventable hospitalizations for asthma among children 2 to 17 years old between 2016 and 2020. Presents data on the rate of potentially preventable hospitalizations for pediatric asthma by hospital characteristics and patient demographics, including the rural classification of hospitals and patient residence.
Author(s): Marvellous Akinlotan, Nima Khodakarami, Gogoal Falia, Alva O. Ferdinand
Date: 04/2026
Sponsoring organization: Southwest Rural Health Research Center
view details