Rural Hospitals – Resources
Selected recent or important resources focusing on Rural Hospitals.
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
Type: Document
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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
Type: Document
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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
Type: Document
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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
Type: Document
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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
Type: Document
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
Type: Document
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
Type: Document
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
Type: Document
Sponsoring organization: KFF
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Health Equity at the Center of Rural Care
Podcast episode featuring a discussion with Terry Scoggin, CEO of Titus Regional Medical Center, on how the organization has designed a system of care to ensure equitable access to care for every patient. Highlights how the American Hospital Association's Health Equity Roadmap supported the equity initiative and influenced culture change within the organization.
Date: 12/2024
Type: Audio
Sponsoring organization: American Hospital Association
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Podcast episode featuring a discussion with Terry Scoggin, CEO of Titus Regional Medical Center, on how the organization has designed a system of care to ensure equitable access to care for every patient. Highlights how the American Hospital Association's Health Equity Roadmap supported the equity initiative and influenced culture change within the organization.
Date: 12/2024
Type: Audio
Sponsoring organization: American Hospital Association
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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
Type: Document
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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
Type: Document
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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
Type: Document
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
Type: Document
Sponsoring organization: National Center for Health Statistics
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The Potential for Hospital System Integration to Improve the Financial Outlook of Rural Hospitals in the United States
Provides an overview of the current financial status of rural hospitals and their risk of closure, as defined by days of cash on hand and total margins. Discusses the impact of rural hospital closures on local communities, including on health outcomes, demographics, and the economy. Explores the extent to which affiliating with, merging with, or being acquired by a larger hospital system can impact the financial position of rural hospitals.
Author(s): Al Dobson, Michael Beins, Patrick McMahon, et al.
Date: 11/2024
Type: Document
Sponsoring organizations: Coalition to Strengthen America's Healthcare, Dobson DaVanzo & Associates
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Provides an overview of the current financial status of rural hospitals and their risk of closure, as defined by days of cash on hand and total margins. Discusses the impact of rural hospital closures on local communities, including on health outcomes, demographics, and the economy. Explores the extent to which affiliating with, merging with, or being acquired by a larger hospital system can impact the financial position of rural hospitals.
Author(s): Al Dobson, Michael Beins, Patrick McMahon, et al.
Date: 11/2024
Type: Document
Sponsoring organizations: Coalition to Strengthen America's Healthcare, Dobson DaVanzo & Associates
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CY 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1809-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 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; incorporating an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 11/2024
Type: Document
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 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; incorporating an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 11/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Understanding the Impact of Medical Debt in Rural Communities: Perspectives from Rural Hospital Administrators
Presents findings from key informant interviews with rural hospital administrators across seven states regarding the impact of medical debt on hospitals and patients in rural communities. Describes themes related to causes and consequences of medical debt across three domains: hospital, patient/community, and policy.
Author(s): Mariana Tuttle, Ingrid Jacobson, Katie Rydberg, Carrie Henning-Smith
Date: 11/2024
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Presents findings from key informant interviews with rural hospital administrators across seven states regarding the impact of medical debt on hospitals and patients in rural communities. Describes themes related to causes and consequences of medical debt across three domains: hospital, patient/community, and policy.
Author(s): Mariana Tuttle, Ingrid Jacobson, Katie Rydberg, Carrie Henning-Smith
Date: 11/2024
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Last Updated: 1/13/2025