Critical Access Hospitals (CAHs) – Resources
Selected recent or important resources focusing on Critical Access Hospitals (CAHs).
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
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
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
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
Sponsoring organization: Flex Monitoring Team
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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).
Additional links: Report in Brief
Date: 09/2022
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).
Additional links: Report in Brief
Date: 09/2022
Sponsoring organization: Office of Inspector General (HHS)
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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
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
Sponsoring organization: National Rural Health Resource Center
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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
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
Sponsoring organization: North Carolina Rural Health Research Program
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Barriers and Facilitators Associated With Establishment of Emergency Department-Initiated Buprenorphine for Opioid Use Disorder in Rural Maine
Presents a study on the barriers and facilitators for implementing programs that initiate buprenorphine treatment for patients with opioid use disorder (OUD) seeking care in critical access hospital (CAH) emergency departments (EDs) in rural Maine. Highlights findings of a survey of CAH ED directors on the challenges of implementing buprenorphine initiation programs.
Author(s): Noah K. Rosenberg, Alexander B. Hill, Lily Johnsky, et al.
Citation: Journal of Rural Health, 38(3), 612-619
Date: 06/2022
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Presents a study on the barriers and facilitators for implementing programs that initiate buprenorphine treatment for patients with opioid use disorder (OUD) seeking care in critical access hospital (CAH) emergency departments (EDs) in rural Maine. Highlights findings of a survey of CAH ED directors on the challenges of implementing buprenorphine initiation programs.
Author(s): Noah K. Rosenberg, Alexander B. Hill, Lily Johnsky, et al.
Citation: Journal of Rural Health, 38(3), 612-619
Date: 06/2022
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Supporting Critical Access Hospital Staff during COVID-19
Presents summaries of initiatives taken in three Critical Access Hospitals (CAHs) to support staff during the COVID-19 pandemic with regard to child care, stress and well-being, and work flexibility. Discusses similarities across these programs and offers considerations for CAHs interested in implementing similar initiatives.
Author(s): Madeleine Pick, Megan Lahr, Shehrose Charania, Ira Moscovice
Date: 06/2022
Sponsoring organization: Flex Monitoring Team
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Presents summaries of initiatives taken in three Critical Access Hospitals (CAHs) to support staff during the COVID-19 pandemic with regard to child care, stress and well-being, and work flexibility. Discusses similarities across these programs and offers considerations for CAHs interested in implementing similar initiatives.
Author(s): Madeleine Pick, Megan Lahr, Shehrose Charania, Ira Moscovice
Date: 06/2022
Sponsoring organization: Flex Monitoring Team
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Impact of Cost Report on CAH Decision Making
Webinar recording discussing cost-based reimbursement and the implications of the Medicare cost report for Critical Access Hospitals (CAHs). Describes opportunities for CAHs to maximize reimbursement using the cost report. Part of a series of webinars directed toward rural hospital CEOs and CFOs. Transcript available in video description.
Date: 04/2022
Sponsoring organizations: Oklahoma Office of Rural Health, Stroudwater Associates
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Webinar recording discussing cost-based reimbursement and the implications of the Medicare cost report for Critical Access Hospitals (CAHs). Describes opportunities for CAHs to maximize reimbursement using the cost report. Part of a series of webinars directed toward rural hospital CEOs and CFOs. Transcript available in video description.
Date: 04/2022
Sponsoring organizations: Oklahoma Office of Rural Health, Stroudwater Associates
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Sliding Fee Scale Discount Guide for CAHs and RHCs
Provides concepts and guidance to help Critical Access Hospital (CAH) and Rural Health Clinic (RHC) executives and management teams develop a sliding fee scale discount program. Addresses how these programs relate to Internal Revenue Code Section 501(r) compliance and participation in the National Health Service Corps (NHSC). Includes an example of a sliding fee schedule.
Date: 04/2022
Sponsoring organization: National Rural Health Resource Center
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Provides concepts and guidance to help Critical Access Hospital (CAH) and Rural Health Clinic (RHC) executives and management teams develop a sliding fee scale discount program. Addresses how these programs relate to Internal Revenue Code Section 501(r) compliance and participation in the National Health Service Corps (NHSC). Includes an example of a sliding fee schedule.
Date: 04/2022
Sponsoring organization: National Rural Health Resource Center
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An Inventory of State Flex Program Population Health Initiatives for Fiscal Years 2019-2023
Provides an overview of Medicare Rural Hospital Flexibility (Flex) Program funding for initiatives to improve rural population health under Program Area 3: Population Health Improvement. Offers a state-by-state summary of State Flex Program (SFP) population health initiatives between fiscal years 2019 and 2021. Details output and process measures, outcome measures, and SFP partners for each initiative.
Author(s): Celia Jewell, Sara Kahn-Troster, Zachariah Croll, John Gale
Date: 03/2022
Sponsoring organization: Flex Monitoring Team
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Provides an overview of Medicare Rural Hospital Flexibility (Flex) Program funding for initiatives to improve rural population health under Program Area 3: Population Health Improvement. Offers a state-by-state summary of State Flex Program (SFP) population health initiatives between fiscal years 2019 and 2021. Details output and process measures, outcome measures, and SFP partners for each initiative.
Author(s): Celia Jewell, Sara Kahn-Troster, Zachariah Croll, John Gale
Date: 03/2022
Sponsoring organization: Flex Monitoring Team
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Last Updated: 4/1/2025