Critical Access Hospitals (CAHs) – Resources
Selected recent or important resources focusing on Critical Access Hospitals (CAHs).
State Flex Program Staff Sustainability Guide and Toolkit
A guide for state Flex Programs to help recruit good Flex Program staff, train them successfully, retain staff longer, and plan an orderly process of finding and training new staff before the outgoing staff leave. Presents a Staff Sustainability Cycle, a process for improving the retention of high-performing Flex Program staff, and outlines specific strategies and practical tools for addressing each component of the cycle.
Date: 07/2026
Sponsoring organization: National Rural Health Resource Center
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A guide for state Flex Programs to help recruit good Flex Program staff, train them successfully, retain staff longer, and plan an orderly process of finding and training new staff before the outgoing staff leave. Presents a Staff Sustainability Cycle, a process for improving the retention of high-performing Flex Program staff, and outlines specific strategies and practical tools for addressing each component of the cycle.
Date: 07/2026
Sponsoring organization: National Rural Health Resource Center
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Twenty-Five Years of Progress: Evidence-Based Strategies for Rural Hospital Replacement
Recording of a conference presentation exploring the financial and operational performance of Critical Access Hospitals (CAHs) before and after a facility replacement. Describes trends across successful replacement projects and profiles Rio Grande Hospital in Del Norte, Colorado. Includes a demonstration of the Stroudwater Capital Partners CAH Replacement Directory.
Additional links: Presentation Slides
Date: 06/2026
Sponsoring organization: Stroudwater Associates
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Recording of a conference presentation exploring the financial and operational performance of Critical Access Hospitals (CAHs) before and after a facility replacement. Describes trends across successful replacement projects and profiles Rio Grande Hospital in Del Norte, Colorado. Includes a demonstration of the Stroudwater Capital Partners CAH Replacement Directory.
Additional links: Presentation Slides
Date: 06/2026
Sponsoring organization: Stroudwater Associates
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Concordance Between Social Needs Screening and Availability of Associated Programs in US Hospitals
Examines the extent to which hospitals screen patients for social needs by analyzing data from the 2022 American Hospital Association (AHA) survey. Explores the alignment between hospitals that screen for social needs and the availability of programs to address those needs. Compares data on social needs screening and corresponding programs at hospitals by rural and urban location, Critical Access Hospital (CAH) status, region, ownership, and participation in Accountable Care Organizations (ACOs).
Author(s): Khyathi Gadag, Keith Mueller, Whitney E. Zahnd
Date: 06/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Examines the extent to which hospitals screen patients for social needs by analyzing data from the 2022 American Hospital Association (AHA) survey. Explores the alignment between hospitals that screen for social needs and the availability of programs to address those needs. Compares data on social needs screening and corresponding programs at hospitals by rural and urban location, Critical Access Hospital (CAH) status, region, ownership, and participation in Accountable Care Organizations (ACOs).
Author(s): Khyathi Gadag, Keith Mueller, Whitney E. Zahnd
Date: 06/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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'Good Stewards': Rural Healthcare Experts Discuss Governance Board Best Practices
Provides an overview of hospital and health center boards, with insights from rural CEOs and board members in Colorado, Missouri, North Dakota, and Oklahoma and experts from national organizations. Discusses board orientation and ongoing education, as well as ways to improve board governance.
Author(s): Allee Mead
Citation: Rural Monitor
Date: 06/2026
Sponsoring organization: Rural Health Information Hub
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Provides an overview of hospital and health center boards, with insights from rural CEOs and board members in Colorado, Missouri, North Dakota, and Oklahoma and experts from national organizations. Discusses board orientation and ongoing education, as well as ways to improve board governance.
Author(s): Allee Mead
Citation: Rural Monitor
Date: 06/2026
Sponsoring organization: Rural Health Information Hub
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MBQIP Quality Measures National Annual Report - 2024
Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2024. Presents data on the five Medicare Beneficiary Quality Improvement Project (MBQIP) domains: global measures, patient safety, patient engagement, care coordination, and emergency department.
Date: 06/2026
Sponsoring organization: Flex Monitoring Team
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Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2024. Presents data on the five Medicare Beneficiary Quality Improvement Project (MBQIP) domains: global measures, patient safety, patient engagement, care coordination, and emergency department.
Date: 06/2026
Sponsoring organization: Flex Monitoring Team
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Quality Improvement Workbook
Outlines seven steps of the quality improvement process. Offers interactive worksheets to help Critical Access Hospitals develop and support quality improvement goals and projects.
Date: 06/2026
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
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Outlines seven steps of the quality improvement process. Offers interactive worksheets to help Critical Access Hospitals develop and support quality improvement goals and projects.
Date: 06/2026
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
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MBQIP Measure Core Set Information Guide
Provides an overview of the 2026 Core Measure Set adopted by the Federal Office of Rural Health Policy (FORHP) for use in the Medicare Beneficiary Quality Improvement Project (MBQIP). Offers descriptions, rationales, data elements, data availability, resources, and more for each new and continuing measure.
Date: 05/2026
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
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Provides an overview of the 2026 Core Measure Set adopted by the Federal Office of Rural Health Policy (FORHP) for use in the Medicare Beneficiary Quality Improvement Project (MBQIP). Offers descriptions, rationales, data elements, data availability, resources, and more for each new and continuing measure.
Date: 05/2026
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
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CAH Financial Indicators Report: Summary of Indicator Medians by State
Presents state and national median values of 30 financial indicators included in the Critical Access Hospital Measurement and Performance Assessment System (CAHMPAS). Provides an overview of each measurement and reports median values by state. Indicators represent seven areas of financial performance: profitability, liquidity, capital structure, revenue, cost, utilization, and other.
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Presents state and national median values of 30 financial indicators included in the Critical Access Hospital Measurement and Performance Assessment System (CAHMPAS). Provides an overview of each measurement and reports median values by state. Indicators represent seven areas of financial performance: profitability, liquidity, capital structure, revenue, cost, utilization, and other.
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Payer Mix Shifts and Profitability at Critical Access Hospitals, 2011 to 2023
Analyzes 1,384 Critical Access Hospitals between 2011 and 2023 to determine the impact of changes in commercial, Medicare, Medicaid, and uncompensated care on their finances. Discusses reimbursement policy based on study findings.
Author(s): Yusheng Jia, Yue Li, Xueya Cai, Samuel J. Enumah
Citation: Health Affairs Scholar, 4(4)
Date: 04/2026
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Analyzes 1,384 Critical Access Hospitals between 2011 and 2023 to determine the impact of changes in commercial, Medicare, Medicaid, and uncompensated care on their finances. Discusses reimbursement policy based on study findings.
Author(s): Yusheng Jia, Yue Li, Xueya Cai, Samuel J. Enumah
Citation: Health Affairs Scholar, 4(4)
Date: 04/2026
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2025 National CAH Quality Inventory & Assessment National Report
Presents a high-level summary of key data points from the September-November 2025 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; median swing bed admissions and swing bed length of stay; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; CAH quality payment model participation; and CAH quality improvement topic priorities.
Author(s): Madeleine Pick, Robert Barclay
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Presents a high-level summary of key data points from the September-November 2025 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; median swing bed admissions and swing bed length of stay; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; CAH quality payment model participation; and CAH quality improvement topic priorities.
Author(s): Madeleine Pick, Robert Barclay
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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