Rural Hospitals – Resources
Selected recent or important resources focusing on Rural Hospitals.
Availability of Hospital-Based Obstetric Services in the United States by County, 2010–2023: A State-by-State Report
Provides national, state, and county-specific information on changes in obstetric care access from 2010-2023. Displays county-level maps of changes in hospital-based services availability between 2010-2023, highlighting changes from 2022 to 2023. Features statistics with breakdowns by urban and rural counties.
Author(s): Julia D. Interrante, Kevan O'Hanlon, Katy B. Kozhimannil
Date: 01/2026
Sponsoring organization: University of Minnesota Rural Health Research Center
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Provides national, state, and county-specific information on changes in obstetric care access from 2010-2023. Displays county-level maps of changes in hospital-based services availability between 2010-2023, highlighting changes from 2022 to 2023. Features statistics with breakdowns by urban and rural counties.
Author(s): Julia D. Interrante, Kevan O'Hanlon, Katy B. Kozhimannil
Date: 01/2026
Sponsoring organization: University of Minnesota Rural Health Research Center
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Changes in Bed-Based Measures of Surge Capacity from 2018 to 2022 among Rural and Urban Hospitals
Policy brief describing how hospitals' inpatient capacity changed from 2018-2022 and examining trade-offs between cost-saving reductions and emergency preparedness. Features statistics on hospitals' average daily census (ADC) and number and percentage of unoccupied beds, with breakdowns by year and urban or rural location.
Author(s): Emma Kerr, Tyler Malone, Mark Holmes
Date: 12/2025
Sponsoring organization: North Carolina Rural Health Research Program
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Policy brief describing how hospitals' inpatient capacity changed from 2018-2022 and examining trade-offs between cost-saving reductions and emergency preparedness. Features statistics on hospitals' average daily census (ADC) and number and percentage of unoccupied beds, with breakdowns by year and urban or rural location.
Author(s): Emma Kerr, Tyler Malone, Mark Holmes
Date: 12/2025
Sponsoring organization: North Carolina Rural Health Research Program
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Do Changes in Hospital Ownership Affect Staffing?
Findings brief examining whether transition from government or nonprofit to for-profit hospital ownership is associated with changes in staffing levels in rural hospitals. Utilizes 2011-2023 CMS Healthcare Cost Reporting Information System (HCRIS) data.
Author(s): Ayush Manandhar
Date: 12/2025
Sponsoring organization: North Carolina Rural Health Research Program
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Findings brief examining whether transition from government or nonprofit to for-profit hospital ownership is associated with changes in staffing levels in rural hospitals. Utilizes 2011-2023 CMS Healthcare Cost Reporting Information System (HCRIS) data.
Author(s): Ayush Manandhar
Date: 12/2025
Sponsoring organization: North Carolina Rural Health Research Program
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Community Healers: How Cherokee Indian Hospital Authority Leads in Health and Wellness
Discusses how the Cherokee Indian Hospital Authority (CIHA) addresses the health needs of its community, by integrating Cherokee culture and Western medical care as a way to improve community health. Documents CIHA's work in promoting relationships between federal and state entities and Native Nations.
Author(s): Hailey A. Baker, Mariana Tuttle, Katy Backes Kozhimannil
Date: 12/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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Discusses how the Cherokee Indian Hospital Authority (CIHA) addresses the health needs of its community, by integrating Cherokee culture and Western medical care as a way to improve community health. Documents CIHA's work in promoting relationships between federal and state entities and Native Nations.
Author(s): Hailey A. Baker, Mariana Tuttle, Katy Backes Kozhimannil
Date: 12/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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In Rural Communities, Where Child Care Is Often Scarce, Healthcare Organizations Are Finding Creative Ways to Help
Features rural healthcare organizations in Indiana, North Dakota, and Wisconsin that have partnered with childcare providers, schools, and other organizations to support affordable child care in their communities.
Citation: Rural Monitor
Date: 12/2025
Sponsoring organization: Rural Health Information Hub
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Features rural healthcare organizations in Indiana, North Dakota, and Wisconsin that have partnered with childcare providers, schools, and other organizations to support affordable child care in their communities.
Citation: Rural Monitor
Date: 12/2025
Sponsoring organization: Rural Health Information Hub
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Availability of Higher-Level Neonatal Care Services in Rural US Counties, 2010-2022
Policy brief showing changes in availability of higher-level neonatal care in rural counties from 2010 to 2022, and how this availability differs by rural county type. Features statistics with breakdowns by all rural, micropolitan, and noncore areas.
Author(s): Katy Backes Kozhimannil, Emily C. Sheffield, Julia D. Interrante, et al.
Date: 12/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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Policy brief showing changes in availability of higher-level neonatal care in rural counties from 2010 to 2022, and how this availability differs by rural county type. Features statistics with breakdowns by all rural, micropolitan, and noncore areas.
Author(s): Katy Backes Kozhimannil, Emily C. Sheffield, Julia D. Interrante, et al.
Date: 12/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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What to Ask (About) a Hospital
Describes payment and financial considerations for hospitals as it relates to the hospital's organizational structure, type of care provided, location, patient population, training programs, and alternative payment models. Discusses rural considerations throughout with a close analysis in Section 6: How a Hospital's Location Matters.
Author(s): Christine H. Monahan, Kennah Watts, Julia Burleson, Rachel Swindle, Ariel Winter
Date: 11/2025
Sponsoring organizations: Blood Cancer United, Georgetown University's Center on Health Insurance Reforms (CHIR)
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Describes payment and financial considerations for hospitals as it relates to the hospital's organizational structure, type of care provided, location, patient population, training programs, and alternative payment models. Discusses rural considerations throughout with a close analysis in Section 6: How a Hospital's Location Matters.
Author(s): Christine H. Monahan, Kennah Watts, Julia Burleson, Rachel Swindle, Ariel Winter
Date: 11/2025
Sponsoring organizations: Blood Cancer United, Georgetown University's Center on Health Insurance Reforms (CHIR)
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Calendar Year 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Final Rule (CMS-1834-FC)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2026. Summarizes provisions regarding changes to hospital price transparency; Intensive Outpatient Program (IOP) and partial hospital program rate setting; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; hospital quality start ratings; and more.
Date: 11/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2026. Summarizes provisions regarding changes to hospital price transparency; Intensive Outpatient Program (IOP) and partial hospital program rate setting; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; hospital quality start ratings; and more.
Date: 11/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Hospital Financial Distress: Relative Risk in 2025
Infographic with a state-level map showing the number and percent of rural hospitals in each state at highest relative financial distress risk in 2025. Features statistics showing states with multiple hospitals, one hospital, and no hospitals at highest risk. Includes information on states with highest percentage of rural hospitals at highest relative risk of financial distress.
Author(s): Tyler Malone, George Pink, Julie Perry, Mark Holmes
Date: 11/2025
Sponsoring organizations: North Carolina Rural Health Research Program, The Cecil G. Sheps Center for Health Services Research
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Infographic with a state-level map showing the number and percent of rural hospitals in each state at highest relative financial distress risk in 2025. Features statistics showing states with multiple hospitals, one hospital, and no hospitals at highest risk. Includes information on states with highest percentage of rural hospitals at highest relative risk of financial distress.
Author(s): Tyler Malone, George Pink, Julie Perry, Mark Holmes
Date: 11/2025
Sponsoring organizations: North Carolina Rural Health Research Program, The Cecil G. Sheps Center for Health Services Research
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Third Party Negotiated Hospital Pricing in Rural and Urban Hospitals within 12 U.S. States
Examines the gross and negotiated pricing for common services in rural and urban hospitals. Bases findings on samples from 12 states and focuses on costs of routine care, imaging, and childbirth.
Author(s): Lindsey R. Hammerslag, Aaron P. Smith, Jeffrey C. Talbert
Date: 11/2025
Sponsoring organization: Rural and Underserved Health Research Center
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Examines the gross and negotiated pricing for common services in rural and urban hospitals. Bases findings on samples from 12 states and focuses on costs of routine care, imaging, and childbirth.
Author(s): Lindsey R. Hammerslag, Aaron P. Smith, Jeffrey C. Talbert
Date: 11/2025
Sponsoring organization: Rural and Underserved Health Research Center
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Last Updated: 1/7/2026