Critical Access Hospitals (CAHs) – Resources
Selected recent or important resources focusing on Critical Access Hospitals (CAHs).
Best Practices in Patient Experience at CAHs: Incorporating Lessons from COVID-19
Summarizes findings from an August 2022 meeting of high-performing Critical Access Hospitals regarding best practices for maintaining and improving healthcare quality amid challenges posed by the COVID-19 pandemic and changing healthcare landscape. Provides an overview of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Presents best practices for improving performance by HCAHPS domain. Updates the 2017 publication, A Study of HCAHPS Best Practices in High Performing Critical Access Hospitals.
Additional links: Summary
Date: 11/2022
Type: Document
Sponsoring organization: Stratis Health
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Summarizes findings from an August 2022 meeting of high-performing Critical Access Hospitals regarding best practices for maintaining and improving healthcare quality amid challenges posed by the COVID-19 pandemic and changing healthcare landscape. Provides an overview of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Presents best practices for improving performance by HCAHPS domain. Updates the 2017 publication, A Study of HCAHPS Best Practices in High Performing Critical Access Hospitals.
Additional links: Summary
Date: 11/2022
Type: Document
Sponsoring organization: Stratis Health
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Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Acquisition; Rural Emergency Hospitals: Payment Policies, Conditions of Participation, Provider Enrollment, Physician Self-Referral; New Service Category for Hospital Outpatient Department Prior Authorization Process; Overall Hospital Quality Star Rating; COVID-19
Establishes the Rural Emergency Hospital (REH) provider type. Outlines REH payment policy, Conditions of Participation (CoPs), quality measures, and enrollment policy. Outlines changes to the Critical Access Hospitals (CAH) CoPs regarding location and distance requirements, patient's rights requirements, and flexibilities for CAHs that are part of a larger health system. Among other things, this rule also revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and finalizes provisions included in the COVID-19 interim final rules.
Additional links: Fact Sheet
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Establishes the Rural Emergency Hospital (REH) provider type. Outlines REH payment policy, Conditions of Participation (CoPs), quality measures, and enrollment policy. Outlines changes to the Critical Access Hospitals (CAH) CoPs regarding location and distance requirements, patient's rights requirements, and flexibilities for CAHs that are part of a larger health system. Among other things, this rule also revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and finalizes provisions included in the COVID-19 interim final rules.
Additional links: Fact Sheet
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Financial Characteristics of Critical Access Hospitals (CAHs) Participating in Accountable Care Organizations (ACO)
Examines Critical Access Hospital (CAH) participation in Medicare and non-Medicare Accountable Care Organizations (ACOs) in 2019. Compares the organizational and financial characteristics of CAHs across facilities that participate in ACOs and those that do not participate in an ACO. Includes data on profitability, liquidity, outpatient revenue, and Medicare payer mix.
Author(s): Angelina Budko, George Pink, Susie Gurzenda, Ann Howard, Kristin L. Reiter
Date: 11/2022
Type: Document
Sponsoring organization: Flex Monitoring Team
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Examines Critical Access Hospital (CAH) participation in Medicare and non-Medicare Accountable Care Organizations (ACOs) in 2019. Compares the organizational and financial characteristics of CAHs across facilities that participate in ACOs and those that do not participate in an ACO. Includes data on profitability, liquidity, outpatient revenue, and Medicare payer mix.
Author(s): Angelina Budko, George Pink, Susie Gurzenda, Ann Howard, Kristin L. Reiter
Date: 11/2022
Type: Document
Sponsoring organization: Flex Monitoring Team
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Delivery of Cancer Screening and Treatment in Critical Access Hospitals
Summarizes results of a survey of 135 Critical Access Hospitals (CAHs) regarding cancer screening and treatment provided by CAHs. Describes the role of visiting providers and the use of telemedicine in cancer screening and treatment.
Author(s): Megan Lahr, Xiomara Santana, Helen Parsons, Nathan Bean, Ira Moscovice
Date: 10/2022
Type: Document
Sponsoring organization: Flex Monitoring Team
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Summarizes results of a survey of 135 Critical Access Hospitals (CAHs) regarding cancer screening and treatment provided by CAHs. Describes the role of visiting providers and the use of telemedicine in cancer screening and treatment.
Author(s): Megan Lahr, Xiomara Santana, Helen Parsons, Nathan Bean, Ira Moscovice
Date: 10/2022
Type: Document
Sponsoring organization: Flex Monitoring Team
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Small Rural Hospitals with Low-Volume Emergency Departments that May Convert to a Rural Emergency Hospital (REH)
Explores a variety of characteristics of Critical Access Hospitals (CAHs) and rural hospitals eligible to convert to the Rural Emergency Hospital (REH) designation, including patient volume, services and technology, EMS, and clinical staffing characteristics. Compares eligible hospitals by emergency department volume in 2019. Summarizes observations made by emergency department physician advisers regarding this data and REH implementation concerns.
Author(s): Margaret Greenwood-Ericksen, TJ Grant, Susie Gurzenda, et al.
Date: 10/2022
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Explores a variety of characteristics of Critical Access Hospitals (CAHs) and rural hospitals eligible to convert to the Rural Emergency Hospital (REH) designation, including patient volume, services and technology, EMS, and clinical staffing characteristics. Compares eligible hospitals by emergency department volume in 2019. Summarizes observations made by emergency department physician advisers regarding this data and REH implementation concerns.
Author(s): Margaret Greenwood-Ericksen, TJ Grant, Susie Gurzenda, et al.
Date: 10/2022
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Medicare Part B Overpaid and Beneficiaries Incurred Cost-Share Overcharges of Over $1 Million for the Same Professional Services
Results of an audit of Medicare Part B claims to determine whether Part B payments to Critical Access Hospitals (CAHs) for professional services and payments made to healthcare practitioners for the same services complied with federal requirements. Includes recommendations from the Office of Inspector General (OIG), and the response from the Centers for Medicare & Medicaid Services (CMS).
Date: 09/2022
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Results of an audit of Medicare Part B claims to determine whether Part B payments to Critical Access Hospitals (CAHs) for professional services and payments made to healthcare practitioners for the same services complied with federal requirements. Includes recommendations from the Office of Inspector General (OIG), and the response from the Centers for Medicare & Medicaid Services (CMS).
Date: 09/2022
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Self-reported Illness Experiences and Psychosocial Outcomes for Reservation-Area American Indian Youth During COVID-19
Results of a Spring 2021 study of 2,559 American Indian students in grades 6-12 in schools on or near Indian reservations. Features statistics on COVID-19 experiences for self and others.
Author(s): Linda R. Stanley, Meghan A. Crabtree, Randall C. Swaim, Mark A. Prince.
Citation: JAMA Network Open, 5(9), e2231764
Date: 09/2022
Type: Document
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Results of a Spring 2021 study of 2,559 American Indian students in grades 6-12 in schools on or near Indian reservations. Features statistics on COVID-19 experiences for self and others.
Author(s): Linda R. Stanley, Meghan A. Crabtree, Randall C. Swaim, Mark A. Prince.
Citation: JAMA Network Open, 5(9), e2231764
Date: 09/2022
Type: Document
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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: 08/2022
Type: Document
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: 08/2022
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Experience in the Pennsylvania Rural Health Model: Barnes-Kasson County Hospital
Profiles Barnes-Kasson County Hospital, a Critical Access Hospital with three hospital-based Rural Health Clinics and a skilled nursing facility in Pennsylvania. Discusses the CAH's experience participating in the Pennsylvania Rural Health Model (PARHM). Describes the Barnes-Kasson transformation plan, challenges of the global budget model, peer learning and networking opportunities, and next steps.
Date: 08/2022
Type: Document
Sponsoring organization: Rural Health Value
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Profiles Barnes-Kasson County Hospital, a Critical Access Hospital with three hospital-based Rural Health Clinics and a skilled nursing facility in Pennsylvania. Discusses the CAH's experience participating in the Pennsylvania Rural Health Model (PARHM). Describes the Barnes-Kasson transformation plan, challenges of the global budget model, peer learning and networking opportunities, and next steps.
Date: 08/2022
Type: Document
Sponsoring organization: Rural Health Value
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Changes in the Provision of Health Care Services by Rural Critical Access Hospitals and Prospective Payment System Hospitals in 2009 compared to 2017
Findings brief exploring changes in the availability and provision of different health care services among rural Critical Access Hospitals and Prospective Payment System hospitals from 2009 to 2017, using data from the American Hospital Association Annual Survey Database. Features statistics with breakdowns by types of services offered, type of hospital, and percentage-point change from 2009 to 2017.
Author(s): Randall John, Kathleen Knocke, Sharita Thomas, et al.
Date: 08/2022
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Findings brief exploring changes in the availability and provision of different health care services among rural Critical Access Hospitals and Prospective Payment System hospitals from 2009 to 2017, using data from the American Hospital Association Annual Survey Database. Features statistics with breakdowns by types of services offered, type of hospital, and percentage-point change from 2009 to 2017.
Author(s): Randall John, Kathleen Knocke, Sharita Thomas, et al.
Date: 08/2022
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Last Updated: 3/28/2024