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Rural Health
Resources by Topic: Sole Community Hospitals

Medicaid: States' Use and Distribution of Supplemental Payments to Hospitals
Examines the use of disproportionate share hospital (DSH) payments given to hospitals with more Medicaid and uninsured patients. Addresses differences in state Medicaid expansion status, uninsured percentage, and uncompensated care in relation to DSH payments. Includes state data on DSH payments and uncompensated care costs by rural/urban hospital location, as well as data on Critical Access Hospital (CAH) and Sole Community Hospital DSH payments by state.
Additional links: Full Report
Date: 07/2019
Sponsoring organization: Government Accountability Office
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Guadalupe County Hospital Surpassing Six Month SRHT Goals
Features a Sole Community Hospital in Santa Rosa, New Mexico that participated in the Small Rural Hospital Transition (SRHT) project. Focuses on their use of LEAN to reduce days net accounts receivable, as well as their increase in services provided, non-measurable impacts, and more.
Date: 01/2019
Sponsoring organization: National Rural Health Resource Center
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Drug Discount Program: Characteristics of Hospitals Participating and Not Participating in the 340B Program
Analyzes 2016 cost report data to describe and compare characteristics of 340B participating and non-participating hospitals, specifically examining three hospital types: Critical Access Hospitals (CAHs), Sole Community Hospitals (SCHs), and general acute care hospitals. Discusses trends related to decreased charity care and an increase in Medicaid expansion on 340B hospital participation.
Additional links: Full Report
Date: 07/2018
Sponsoring organization: Government Accountability Office
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Differences in Community Characteristics of Sole Community Hospitals
Findings brief presenting a snapshot of Sole Community Hospitals (SCHs) and their communities in 2015, and identifying trends in characteristics of selected SCHs and their communities from 2006 through 2015. Features statistics including breakdowns by large rural, small rural, and isolated rural location.
Author(s): Sharita R. Thomas, Mark Holmes, George H. Pink
Date: 11/2017
Sponsoring organization: North Carolina Rural Health Research Program
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2012-14 Profitability of Urban and Rural Hospitals by Medicare Payment Classification
Compares the total margin and operating margin of rural and urban hospitals using 2012-2014 profitability data. Analysis divides rural hospitals by the size of the prospective payment system and by the Medicare payment classification – Critical Access Hospitals (CAHs), Medicare dependent hospitals, sole community hospitals, and rural referral centers.
Author(s): Sharita R. Thomas, G. Mark Holmes, George H. Pink
Date: 03/2016
Sponsoring organization: North Carolina Rural Health Research Program
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Geographic Variation in the Profitability of Urban and Rural Hospitals
Analyzes and compares the 2014 profitability margins of rural and urban hospitals by census region, census division, and by state. Provides information on rural hospitals broken down by Critical Access Hospitals (CAHs) and other rural hospitals; the other rural hospitals group includes Medicare dependent hospitals, sole community hospitals, and rural prospective payment system hospitals.
Author(s): Sharita R. Thomas, George H. Pink, G. Mark Holmes
Date: 03/2016
Sponsoring organization: North Carolina Rural Health Research Program
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Hospital Policy Issues: Statement by Mark Miller, Medicare Payment Advisory Commission before Subcommittee on Health, Committee on Ways and Means, U.S. House of Representatives
Testimony from the Medicare Payment Advisory Commission's executive director presented at a July 22nd, 2015, Ways and Means subcommittee hearing concerning Medicare hospital payment issues, rural health issues, and beneficiary access to care. Discusses Medicare's rural hospital payment adjustments, how they impact access to care, and principles to consider in evaluating rural add-on payments. Also discusses MedPAC recommendations related to graduate medical education (GME), including some related to rural training.
Author(s): Mark E. Miller
Date: 07/2015
Sponsoring organizations: House Ways and Means Committee, Subcommittee on Health, Medicare Payment Advisory Commission
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Sole Community Hospitals: Early Indications Show That TRICARE's Revised Reimbursement Rules Have Not Affected Access to Care
Reports on the impact of a January 2014 revision to TRICARE's reimbursement for Sole Community Hospitals (SCHs), which serve primarily rural areas. The new TRICARE reimbursement rules approximate Medicare's for these hospitals. Looks at the impact of revised SCH reimbursement on healthcare access for servicemembers and their dependents. Findings based on claims data, as well as interviews with 10 SCHs and with national stakeholders. Appendices include information on SCHs with a high number of TRICARE admissions.
Additional links: Full Report
Date: 04/2015
Sponsoring organization: Government Accountability Office
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Implications of Proposed Changes to Rural Hospital Payment Designations
Discusses the short-term policy implications of proposed changes to the designation and payment guidelines for small rural hospitals. Focuses on proposed changes to rural Medicare payments for hospitals and physicians, as well as a proposal to change the CAH distance requirements.
Date: 12/2012
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Trends in the Provision of Surgery by Rural Hospitals
Examines changes in the number of rural hospitals that provided surgery between 2001 and 2008. Shows results based on hospital location and Medicare payment classification.
Author(s): George M. Holmes, Saleema A. Karim, George H. Pink
Date: 07/2011
Sponsoring organization: North Carolina Rural Health Research Program
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