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Rural Health
Resources by Topic: Hospitals

Clarity for Rural Emergency Hospitals and Changes for Critical Access Hospitals: CMS Finalizes Conditions of Participation and Payment and Enrollment Policies But Pauses Stark Law Flexibilities
Provides an overview of the Rural Emergency Hospitals (REHs) provisions of the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule. Discusses REH reimbursement, Conditions of Participation (CoPs), enrollment provisions, and Stark Law regulatory modifications to accommodate REHs. Highlights changes to the definition of "primary roads" related to Critical Access Hospital (CAH) CoPs.
Author(s): Emily Jane Cook, Caroline Reignley, Amber Arnold, Sandra M. DiVarco
Date: 11/2022
Type: Document
Sponsoring organization: McDermott Will & Emery
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National Rural Health Day 2022: Dr. Roxie Wells Talks Hospital Resilience in the Face of Change
Conversation with Dr. Roxie Wells, president of Cape Fear Valley Hoke Hospital, on rural hospital resiliency. Describes the most pressing needs of the Hoke County, North Carolina, community; Cape Fear Valley Hoke Hospital's primary areas of action to address those needs; and the most significant threats the hospital faces to improve community health. Discusses how AHA has helped the hospital successfully confront these challenges.
Date: 11/2022
Type: Video/Multimedia
Sponsoring organization: American Hospital Association
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Future of Population Health Efforts for Rural Health Systems
Slides presented at the Becker's Hospital Review 10th Annual CEO + CFO Roundtable Conference in November 2022. Discusses approaches to understanding and addressing social determinants of health, including community health needs assessments (CHNAs) and Accountable Health Communities (AHCs), and offers links to tools and resources. Highlights needs addressed and implementation challenges faced by two rural AHCs.
Author(s): Keith J. Mueller
Date: 11/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute
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2022 National Healthcare Quality and Disparities Report
Provides a comprehensive summary and data analysis of healthcare quality and access in the U.S. Addresses access to healthcare, patient safety, person-centered care, care coordination, effective treatment, healthy living, and care affordability. Includes a discussion of rural hospital closures and the impact on the distance required to access selected healthcare services.
Date: 11/2022
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Acquisition; Rural Emergency Hospitals: Payment Policies, Conditions of Participation, Provider Enrollment, Physician Self-Referral; New Service Category for Hospital Outpatient Department Prior Authorization Process; Overall Hospital Quality Star Rating; COVID-19
Establishes the Rural Emergency Hospital (REH) provider type. Outlines REH payment policy, Conditions of Participation (CoPs), quality measures, and enrollment policy. Outlines changes to the Critical Access Hospitals (CAH) CoPs regarding location and distance requirements, patient's rights requirements, and flexibilities for CAHs that are part of a larger health system. Among other things, this rule also revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and finalizes provisions included in the COVID-19 interim final rules.
Additional links: Fact Sheet
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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CY 2023 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1772-FC) Rural Emergency Hospitals — New Medicare Provider Type
Provides an overview of Rural Emergency Hospitals, a Medicare provider type established by the Consolidated Appropriations Act, 2021. Details key policies outlined in the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule, including payment policies, conditions of participation, REH provider enrollment, and exceptions to the physician self-referral law.
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Financial Characteristics of Critical Access Hospitals (CAHs) Participating in Accountable Care Organizations (ACO)
Examines Critical Access Hospital (CAH) participation in Medicare and non-Medicare Accountable Care Organizations (ACOs) in 2019. Compares the organizational and financial characteristics of CAHs across facilities that participate in ACOs and those that do not participate in an ACO. Includes data on profitability, liquidity, outpatient revenue, and Medicare payer mix.
Author(s): Angelina Budko, George Pink, Susie Gurzenda, Ann Howard, Kristin L. Reiter
Date: 11/2022
Type: Document
Sponsoring organization: Flex Monitoring Team
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Factors Associated with Compliance to the Hospital Price Transparency Final Rule: A National Landscape Study
Examines 3,558 short-term acute-care hospitals' compliance with the Hospital Price Transparency Rule, which requires that hospitals publicly post a machine-readable file containing commercial negotiated prices for 300 services. Compares hospital compliance by state and hospital referral region. Describes factors associated with compliance, including health information technology preparedness, profit status, system affiliation, hospital size, and rural location.
Author(s): John Xuefeng Jiang, Daniel Polsky, Jeff Littlejohn, et al.
Citation: Journal of General Internal Medicine, 37(14), 3577–3584
Date: 11/2022
Type: Document
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Rural Medicare Beneficiaries are Increasingly Likely to Be Admitted to Urban Hospitals
Examines whether the proportion of rural Medicare fee-for-service beneficiaries admitted to urban hospitals increased between 2010 and 2018 using data from the Hospital Service Area File (HSAF) and the American Hospital Association (AHA) survey. Explores whether distance to the nearest hospital and system affiliation of the nearest rural hospital were associated with increases in urban hospital admissions from rural ZIP codes.
Author(s): Hannah R. Friedman, George Mark Holmes
Citation: Health Services Research, 57(5), 1029-1034
Date: 10/2022
Type: Document
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October 2022 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) October 2022 meeting. Covers Medicaid race and ethnicity data collection and reporting, improving access to Medicaid coverage and care for adults leaving incarceration, the unwinding of the Public Health Emergency, streamlining the delivery of home- and community-based services, potential recommendations for structuring Disproportionate Share Hospital allotments during economic crises, and more. Includes rural references and considerations throughout.
Date: 10/2022
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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