Critical Access Hospitals (CAHs) – Resources
Selected recent or important resources focusing on Critical Access Hospitals (CAHs).
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
Type: Document
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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
Type: Document
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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
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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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
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Critical Access Hospital Financial Sustainability Guide
Provides guidance and assistance to state Medicare Rural Hospital Flexibility (Flex) Program personnel, leaders of Critical Access Hospitals (CAHs), and others helping CAHs manage long-term financial stability. Presents potential interventions CAHs may use to address ongoing and systemic financial challenges in rural healthcare.
Date: 12/2024
Type: Document
Sponsoring organizations: EideBailly, National Rural Health Resource Center
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Provides guidance and assistance to state Medicare Rural Hospital Flexibility (Flex) Program personnel, leaders of Critical Access Hospitals (CAHs), and others helping CAHs manage long-term financial stability. Presents potential interventions CAHs may use to address ongoing and systemic financial challenges in rural healthcare.
Date: 12/2024
Type: Document
Sponsoring organizations: EideBailly, National Rural Health Resource Center
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Strategies for Critical Access Hospitals to Address Outmigration
Provides an overview of factors that may contribute to a rural healthcare facility experiencing bypass or market share loss. Offers strategies to help rural hospitals, Critical Access Hospitals (CAHs), and Rural Health Clinics (RHCs) increase Primary Service Area (PSA) market share and address outmigration.
Date: 12/2024
Type: Document
Sponsoring organizations: Impact! Communications, Inc., National Rural Health Resource Center
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Provides an overview of factors that may contribute to a rural healthcare facility experiencing bypass or market share loss. Offers strategies to help rural hospitals, Critical Access Hospitals (CAHs), and Rural Health Clinics (RHCs) increase Primary Service Area (PSA) market share and address outmigration.
Date: 12/2024
Type: Document
Sponsoring organizations: Impact! Communications, Inc., National Rural Health Resource Center
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CY 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1809-FC)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; incorporating an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 11/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; incorporating an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 11/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Critical Access Hospital: 2025 National Patient Safety Goals
Identifies National Patient Safety Goals for the Joint Commission's Critical Access Hospital Accreditation Program. Covers patient identification, caregiver communication, medication safety, infection prevention, suicide prevention, healthcare equity, and more. Effective January 1, 2025.
Date: 10/2024
Type: Document
Sponsoring organization: Joint Commission
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Identifies National Patient Safety Goals for the Joint Commission's Critical Access Hospital Accreditation Program. Covers patient identification, caregiver communication, medication safety, infection prevention, suicide prevention, healthcare equity, and more. Effective January 1, 2025.
Date: 10/2024
Type: Document
Sponsoring organization: Joint Commission
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CAH Perspectives on Collection and Use of Demographic and Social Drivers of Health Data
Describes how collecting information about social drivers of health (SDOH) can help hospitals inform treatment and discharge planning decisions and identify local health disparities. Summarizes findings from interviews with nine Critical Access Hospital (CAH) staff regarding their experiences collecting demographic and SDOH data. Highlights themes related to challenges CAH staff face in collecting this data and how CAHs utilize the data they collect.
Author(s): Madeleine Pick, Carson Crane, Megan Lahr
Date: 10/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
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Describes how collecting information about social drivers of health (SDOH) can help hospitals inform treatment and discharge planning decisions and identify local health disparities. Summarizes findings from interviews with nine Critical Access Hospital (CAH) staff regarding their experiences collecting demographic and SDOH data. Highlights themes related to challenges CAH staff face in collecting this data and how CAHs utilize the data they collect.
Author(s): Madeleine Pick, Carson Crane, Megan Lahr
Date: 10/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
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Frontier Community Health Integration Project (FCHIP) Demonstration Extension Fact Sheet
Provides an overview of the Frontier Community Health Integration Project (FCHIP) Demonstration Extension, which tests new healthcare delivery models in the most sparsely populated rural counties. Identifies participating Critical Access Hospitals and models tested.
Date: 10/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the Frontier Community Health Integration Project (FCHIP) Demonstration Extension, which tests new healthcare delivery models in the most sparsely populated rural counties. Identifies participating Critical Access Hospitals and models tested.
Date: 10/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Hospital Differences in Adult Inpatient Stays with Healthcare-Associated Infections, 2019 and 2021
Examines the rate of adult inpatient hospital stays involving five healthcare-associated infections (HAI) in 2019 and 2021. Presents data from an analysis of 2019 and 2021 State Inpatient Databases (SID) from public, non-federal acute-care hospitals across 38 states by hospital characteristics, including ownership, rural or urban location, safety-net designation, and Critical Access Hospital designation.
Author(s): Melissa A. Miller, Leyi Lin, David P. Calfee, Amy Gehrke, Alex Bohl
Date: 10/2024
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Examines the rate of adult inpatient hospital stays involving five healthcare-associated infections (HAI) in 2019 and 2021. Presents data from an analysis of 2019 and 2021 State Inpatient Databases (SID) from public, non-federal acute-care hospitals across 38 states by hospital characteristics, including ownership, rural or urban location, safety-net designation, and Critical Access Hospital designation.
Author(s): Melissa A. Miller, Leyi Lin, David P. Calfee, Amy Gehrke, Alex Bohl
Date: 10/2024
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Medicare Payment Basics: Critical Access Hospitals Payment System
Presents an overview of Medicare payments for Critical Access Hospitals (CAHs). Compares differences in Medicare payments for CAHs, Sole Community Hospitals, and Medicare-Dependent Hospitals.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Presents an overview of Medicare payments for Critical Access Hospitals (CAHs). Compares differences in Medicare payments for CAHs, Sole Community Hospitals, and Medicare-Dependent Hospitals.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Last Updated: 1/6/2025