Rural Hospitals – Resources
Selected recent or important resources focusing on Rural Hospitals.
February 2025 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) February 2025 meeting. Covers transitions of care for children and youth with special healthcare needs (CYSHCN), hospital non-disproportionate share hospital supplemental payments and directed payment targeting, improving access to medications for opioid use disorder, healthcare access for children in foster care, and more. Includes rural references throughout.
Additional links: Hospital Non-DSH Supplemental Payment and Directed Payment Targeting Analyses
Date: 02/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) February 2025 meeting. Covers transitions of care for children and youth with special healthcare needs (CYSHCN), hospital non-disproportionate share hospital supplemental payments and directed payment targeting, improving access to medications for opioid use disorder, healthcare access for children in foster care, and more. Includes rural references throughout.
Additional links: Hospital Non-DSH Supplemental Payment and Directed Payment Targeting Analyses
Date: 02/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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146 Rural Hospitals Closed or Stopped Providing Inpatient Services from 2005 to 2023 in the United States
Author(s): Anil Rupasingha, Julie Cho
Date: 02/2025
Sponsoring organization: USDA Economic Research Service
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Line chart showing the number of rural hospital closures and rural inpatient unit closures between 2005 and 2023.
Author(s): Anil Rupasingha, Julie Cho
Date: 02/2025
Sponsoring organization: USDA Economic Research Service
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National Academy for State Health Policy (NASHP) Hospital Cost Tool
Interactive tool providing information on how much hospitals spend on patient care services, how costs relate to the hospital charges, and actual prices paid by health plans. Presents data on a range of measures for hospital revenue, costs, profitability, and break-even points for over 5,000 hospitals nationwide between 2011 and 2023. Includes the ability to view and compare hospital financial metrics at the hospital, state, and health system levels.
Additional links: Hospital Cost Tool and Resources
Date: 02/2025
Sponsoring organization: National Academy for State Health Policy
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Interactive tool providing information on how much hospitals spend on patient care services, how costs relate to the hospital charges, and actual prices paid by health plans. Presents data on a range of measures for hospital revenue, costs, profitability, and break-even points for over 5,000 hospitals nationwide between 2011 and 2023. Includes the ability to view and compare hospital financial metrics at the hospital, state, and health system levels.
Additional links: Hospital Cost Tool and Resources
Date: 02/2025
Sponsoring organization: National Academy for State Health Policy
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Rural Nonprofit Hospital Community Benefit and Financial Assistance Spending: A Call for Greater Reporting Transparency
Examines the variation in community benefit and financial assistance spending among rural nonprofit hospitals that filed group returns in Wisconsin and Minnesota. Analyzes 2021 nonprofit hospital tax data to explore whether group filers' community benefit spending differed from individual nonprofit hospital filers. Discusses potential implications of policy recommendations that would require nonprofit hospitals to file individual tax returns.
Author(s): Hannah MacDougall, Melissa Latcham, Erica Eliason
Citation: Journal of Rural Health, 41, e12914
Date: 01/2025
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Examines the variation in community benefit and financial assistance spending among rural nonprofit hospitals that filed group returns in Wisconsin and Minnesota. Analyzes 2021 nonprofit hospital tax data to explore whether group filers' community benefit spending differed from individual nonprofit hospital filers. Discusses potential implications of policy recommendations that would require nonprofit hospitals to file individual tax returns.
Author(s): Hannah MacDougall, Melissa Latcham, Erica Eliason
Citation: Journal of Rural Health, 41, e12914
Date: 01/2025
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U.S. Hospital List (2024)
Excel file providing a comprehensive list of urban and rural U.S. hospitals that were reported open as of January 1, 2024. Includes 4,497 acute care hospitals and 1,457 specialty hospitals.
Date: 2025
Sponsoring organization: North Carolina Rural Health Research Program
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Excel file providing a comprehensive list of urban and rural U.S. hospitals that were reported open as of January 1, 2024. Includes 4,497 acute care hospitals and 1,457 specialty hospitals.
Date: 2025
Sponsoring organization: North Carolina Rural Health Research Program
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Associations Between Rural Hospital Closures and Acute and Post-Acute Care Access and Outcomes
Examines the impact of rural hospital closures on hospital and post-acute care (PAC) use and outcomes. Analyzes 32 rural hospital closures and county-level impacts on travel distances, lengths of stay at hospitals, hospital charges, PAC episodes, fall injuries and related mortality and hospitalizations, and population-level hospitalization and death rates. Includes descriptive statistics of 2014-2018 rural hospital closure status.
Author(s): Geoffrey J. Hoffman, Jinkyung Ha, Zhaohui Fan, Jun Li
Citation: Health Services Research
Date: 12/2024
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Examines the impact of rural hospital closures on hospital and post-acute care (PAC) use and outcomes. Analyzes 32 rural hospital closures and county-level impacts on travel distances, lengths of stay at hospitals, hospital charges, PAC episodes, fall injuries and related mortality and hospitalizations, and population-level hospitalization and death rates. Includes descriptive statistics of 2014-2018 rural hospital closure status.
Author(s): Geoffrey J. Hoffman, Jinkyung Ha, Zhaohui Fan, Jun Li
Citation: Health Services Research
Date: 12/2024
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The Pennsylvania Rural Health Model (PARHM): Fourth Annual Evaluation Report
Evaluates the fourth performance year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall healthcare spending. Provides an overview of the model and describes the implementation experience of participating hospitals and payers. Presents a descriptive quantitative assessment of financial performance, spending and utilization, access to care, and quality of care outcomes from 2016, the model's baseline, through 2022. Includes three case studies discussing three themes: experiences with global budget reconciliation, behavioral health transformation, and interactions and alignment between PARHM and other value-based care programs.
Additional links: Appendix, Findings at a Glance
Date: 12/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluates the fourth performance year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall healthcare spending. Provides an overview of the model and describes the implementation experience of participating hospitals and payers. Presents a descriptive quantitative assessment of financial performance, spending and utilization, access to care, and quality of care outcomes from 2016, the model's baseline, through 2022. Includes three case studies discussing three themes: experiences with global budget reconciliation, behavioral health transformation, and interactions and alignment between PARHM and other value-based care programs.
Additional links: Appendix, Findings at a Glance
Date: 12/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Hospital Margins Rebounded in 2023, But Rural Hospitals and Those With High Medicaid Shares Were Struggling More Than Others
Examines hospital margins for non-federal general short-term hospitals in the U.S. from 2018 through 2023, with a focus on operating margins. Analyzes RAND Hospital Data to explore the extent to which hospitals profited or lost money on patient care and other operating activities. Discusses differences in operating margins by hospital characteristics, including hospital ownership type, commercial share, size, rural or urban location, and Medicare rural payment designation.
Date: 12/2024
Sponsoring organization: KFF
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Examines hospital margins for non-federal general short-term hospitals in the U.S. from 2018 through 2023, with a focus on operating margins. Analyzes RAND Hospital Data to explore the extent to which hospitals profited or lost money on patient care and other operating activities. Discusses differences in operating margins by hospital characteristics, including hospital ownership type, commercial share, size, rural or urban location, and Medicare rural payment designation.
Date: 12/2024
Sponsoring organization: KFF
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Effects of Rural Hospital Closures on Nurse Staffing Levels and Health Care Utilization at Nearby Hospitals
Analyzes healthcare utilization and nurse staffing levels when nearby rural hospitals close. Utilizes 2014-2019 American Hospital Association Survey data to examine vocational nurse/licensed practical nurse (LPN), registered nurse (RN), and advanced practice nurse (APN) staffing levels as well as inpatient and outpatient surgical operations and emergency department (ED) visits within 4 years of a hospital closure.
Author(s): Jing Dong, Siying Liu, Asefeh Faraz Covelli, Guido Cataife
Citation: Health Economics, 33(12), 2687-2707
Date: 12/2024
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Analyzes healthcare utilization and nurse staffing levels when nearby rural hospitals close. Utilizes 2014-2019 American Hospital Association Survey data to examine vocational nurse/licensed practical nurse (LPN), registered nurse (RN), and advanced practice nurse (APN) staffing levels as well as inpatient and outpatient surgical operations and emergency department (ED) visits within 4 years of a hospital closure.
Author(s): Jing Dong, Siying Liu, Asefeh Faraz Covelli, Guido Cataife
Citation: Health Economics, 33(12), 2687-2707
Date: 12/2024
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National Hospital Ambulatory Medical Care Survey: 2022 Emergency Department Summary Tables
Provides data on ambulatory care emergency department (ED) hospital visits in 2022. Table 1 provides metropolitan/nonmetropolitan ED visit data based on hospital location.
Date: 11/2024
Sponsoring organization: National Center for Health Statistics
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Provides data on ambulatory care emergency department (ED) hospital visits in 2022. Table 1 provides metropolitan/nonmetropolitan ED visit data based on hospital location.
Date: 11/2024
Sponsoring organization: National Center for Health Statistics
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Last Updated: 3/10/2025