Critical Access Hospitals (CAHs) – Resources

Critical Access Hospital Financial and Operational Best Practices
Webinar recording that discusses rural hospital operations, with a focus on Critical Access Hospitals (CAHs). Covers inpatient services, emergency services, quality improvement, managing revenue cycle, and other financial topics. Transcript is available by clicking the three dots above the video description, then selecting Show Transcript.
Date: 01/2022
Type: Video/Multimedia
Sponsoring organizations: Oklahoma Office of Rural Health, Stroudwater Associates
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The Clinical and Business Cases for Opening a Maternity Care Unit in a CAH
A case study of a rural North Carolina partnership that worked together to add a new wing for a maternity unit at a 25-bed Critical Access Hospital. Explains how the service was planned to be financially viable. Describes maternal and infant health disparities in the region and discusses how this new service will meet the needs of the population with culturally and linguistically accessible care.
Date: 01/2022
Type: Document
Sponsoring organization: American Hospital Association
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Ending Surprise Medical Bills
Offers resources for healthcare providers and consumers regarding surprise billing regulations and policies. Includes information on payment dispute resolution between patients and providers, and between providers and out-of-network health plans.
Date: 2022
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Outcome Measures for State Flex Program Financial and Operational Improvement Interventions
Discusses strategies for State Flex Programs (SFP) to monitor Critical Access Hospital (CAH) financial and operational improvement (FOI) interventions and the underlying theories of the activities. Provides recommendations for short- and intermediate-term outcome measures to assist SFPs in monitoring FOI initiatives.
Author(s): John Gale, Sara Kahn-Troster, Zach Croll
Date: 12/2021
Type: Document
Sponsoring organization: Flex Monitoring Team
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Critical Access Hospitals' Initial Response to COVID-19 by System Affiliation
Summarizes results of a survey of Critical Access Hospital (CAH) executives in eight states regarding the initial response to COVID-19 through August 2020. Presents data by system-affiliated and independent CAH status. Discusses COVID-19 case volume, personal protective equipment (PPE) supply, and the perceived impact of system affiliation status on facilities' overall response to COVID-19.
Author(s): Ira Moscovice, Madeleine Pick, Megan Lahr
Date: 11/2021
Type: Document
Sponsoring organization: Flex Monitoring Team
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Examining Rural Hospital Bypass for Outpatient Services
Explores the drivers of rural hospital bypass for outpatient services and the relationship between hospital outpatient services and inpatient utilization. Examines demographic and market characteristics associated with bypass for outpatient services before and after inpatient admissions. Also analyzes how utilization for common outpatient services differs between Critical Access Hospitals (CAHs) and rural prospective payment system (PPS) hospitals.
Date: 11/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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How Critical Access Hospitals Are Addressing the Social Needs of Rural Populations
Describes Critical Access Hospital (CAH) initiatives that address the social needs of their communities. Summarizes interviews with 14 CAHs and identifies key facilitators and barriers to program success, as well as advice for other CAHs interested in implementing similar programs.
Author(s): Megan Lahr, Tongtan Chantarat, Mariah Quick, Madeleine Pick, Ira Moscovice
Date: 11/2021
Type: Document
Sponsoring organization: Flex Monitoring Team
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2021 CMS Hospital Quality Star Ratings of Rural Hospitals
Results of a study comparing the 2021 Centers for Medicare & Medicaid Services (CMS) Hospital Quality Star Rating results for rural and urban hospitals, comparing the 2021 and 2016 results for rural hospitals, and identifying implications for the usefulness of these ratings for rural hospitals. Features statistics including percentages of hospitals by Star Ratings with breakdowns by urban or rural location, and numbers of unrated rural hospitals by Medicare payment classification, net patient revenue, and census region.
Author(s): Laura Bozovich, Randall John, Kristie Thompson, George H. Pink
Date: 10/2021
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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The Association Between System Affiliation and Financial Performance in Critical Access Hospitals
Examines the association between Critical Access Hospital (CAH) health system affiliation and financial performance as measured by the Critical Access Hospital Measurement and Performance Assessment System (CAHMPAS). Discusses trends in health system affiliation as an alternative to closures as well as potential downsides of affiliation.
Author(s): Laura Bozovich, Kathleen Knocke, George Pink, Ann Howard, Kristin L. Reiter
Date: 10/2021
Type: Document
Sponsoring organization: Flex Monitoring Team
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The Swing Bed Program: Impacting Patients, Providers, and Community
Brief video overview of the swing bed program, which helps rural hospitals provide patient- and community-centric post-acute healthcare. Describes the history, related policy issues, early implementation, and evolution of the program.
Date: 08/2021
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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