Critical Access Hospitals (CAHs) – Resources
Selected recent or important resources focusing on Critical Access Hospitals (CAHs).
January 2025 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2025 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, skilled nursing facility services, home health agency services, inpatient rehabilitation facility services, outpatient dialysis services, and hospice services. Discusses status reports on Medicare Part D, ambulatory surgical centers, and the Medicare Advantage program, as well as policy options for modifying the cost-sharing liability for beneficiaries who receive care at Critical Access Hospitals. Includes rural references and considerations throughout.
Additional links: Reducing Beneficiary Cost-sharing for Outpatient Services at Critical Access Hospitals
Date: 01/2025
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2025 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, skilled nursing facility services, home health agency services, inpatient rehabilitation facility services, outpatient dialysis services, and hospice services. Discusses status reports on Medicare Part D, ambulatory surgical centers, and the Medicare Advantage program, as well as policy options for modifying the cost-sharing liability for beneficiaries who receive care at Critical Access Hospitals. Includes rural references and considerations throughout.
Additional links: Reducing Beneficiary Cost-sharing for Outpatient Services at Critical Access Hospitals
Date: 01/2025
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Location of Critical Access Hospitals
U.S. map showing Critical Access Hospitals (CAHs). Updated quarterly.
Date: 01/2025
Type: Map/Mapping System
Sponsoring organization: Flex Monitoring Team
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U.S. map showing Critical Access Hospitals (CAHs). Updated quarterly.
Date: 01/2025
Type: Map/Mapping System
Sponsoring organization: Flex Monitoring Team
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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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Last Updated: 1/21/2025