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Rural Health Information Hub

Rural Hospitals – Resources

Selected recent or important resources focusing on Rural Hospitals.

Targeted Provider Relief Funds Allocated to Hospitals Had Some Differences with Respect to the Ethnicity and Race of Populations Served
Examines how early Provider Relief Fund Targeted Distributions (Targeted PRF) in 2020 correlated with the racial, ethnic, and economic characteristics of the communities providers serve. Analyzes the Targeted PRF allocations to hospitals and explores if there are statistically significant correlations between PRF per person and the racial, ethnic, and economic composition of the census tracts. Covers four Targeted PRF allocations to COVID-19 High Impact Area Hospitals, Safety Net Hospitals, Rural Hospitals, and Indian Health Service and Tribal Hospitals. Identifies and describes trends in the allotment to rural hospitals.
Date: 07/2023
Sponsoring organization: Office of Inspector General (HHS)
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Early Financial Impact of the COVID-19 Pandemic on U.S. Hospitals
Examines how hospital profitability changed during the first year of the COVID-19 pandemic. Explores the association between COVID-19 infections and hospitalizations and county-level variables to operating margins (OMs) and total margins (TMs). Presents data by hospital characteristics, including size and Critical Access Hospital status, and compares findings from urban and rural hospitals.
Author(s): Kate Li, Mona Al-Amin, Michael D. Rosko
Citation: Journal of Healthcare Management, 68(4), 268-283
Date: 07/2023
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Delta Region Community Health Systems Development (DRCHSD) Program: Revenue Cycle Management Best Practices Guide
Offers rural hospital executives and management teams best practice concepts in revenue cycle management by assisting them in identifying performance improvement within their hospitals and departments. Provides State Offices of Rural Health (SORH) directors and Flex Program coordinators a better understanding of the revenue cycle best practices to help them design educational training programs to support rural hospital administrators with performance improvement.
Additional links: Check List
Date: 07/2023
Sponsoring organizations: BKD CPAs & Advisors, National Rural Health Resource Center
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Provision of Social Care Services by US Hospitals
Explores the extent to which social care services are provided by hospitals. Analyzes data from the 2018 American Hospital Association (AHA) Annual Survey and Community Benefit Insight to identify the number and type of social care services provided by hospitals. Examines whether community and hospital characteristics, including bed size, system affiliation, rurality, neighborhood median income, and state community benefit requirements, are associated with these services.
Author(s): Bradley Iott, Denise Anthony
Citation: The Milbank Quarterly, 101(2), 601-635
Date: 06/2023
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Urban-Rural Disparities in Interfacility Transfers for Children During COVID-19
Presents a study on the rates of rural and urban pediatric interfacility transfers (IFTs) during the COVID-19 pandemic. Compares IFT rates from before the pandemic. Breaks down rural and urban data by medical complexity, transfer type, and census region, among other measures.
Author(s): Corrie E. McDaniel, DO,1,2 JoAnna K. Leyenaar, MD, PhD, MPH,3,4 Mersine A. Bryan, et al
Citation: Journal of Rural Health, 39(3), 611-616
Date: 06/2023
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Rural Hospitals and the New Rural Emergency Hospital Designation
An episode of the Exploring Rural Health podcast featuring Janice Walters, Chief Operating Officer for the Rural Health Redesign Center, home of the Rural Emergency Hospital Technical Assistance Center. Offers an overview of Medicare's Rural Emergency Hospital (REH) designation, which became available on January 1, 2023.
Date: 05/2023
Sponsoring organization: Rural Health Information Hub
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Closed, Converted, Merged, and New Hospitals with Medicare Rural Designations: January 2018-November 2022
Provides an overview of four Medicare rural hospital designations - Critical Access Hospital, Low-Volume Hospital, Medicare Dependent Hospital, and Sole Community Hospital - and factors related to financial distress that these designations are intended to address. Explores the number of rural-designated hospitals that have closed, merged, converted, or opened between January 2018-November 2022 and compares the number of rural-designated hospitals with the number of non-designated hospitals. Outlines considerations for Congress regarding policy options for rural hospitals and access to healthcare services in rural areas.
Date: 04/2023
Sponsoring organization: Congressional Research Service
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Electronic Health Information Exchange: Use Has Increased, but Is Lower for Small and Rural Providers
Explores states' use of Health Information Technology for Economic and Clinical Health (HITECH) Act funding for health information exchange efforts. Examines the extent to which the use of electronic health information exchange has changed since the enactment of the HITECH Act and federal efforts that aim to address challenges to the electronic exchange of health information. Discusses differences in the electronic exchange of information between small and rural hospitals and larger, non-rural hospitals.
Additional links: Full Report
Date: 04/2023
Sponsoring organization: Government Accountability Office
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Analysis of Hospital Operating Margins and Provision of Safety Net Services
Explores the association between five hospital safety net services - undercompensated care measured using the Disproportionate Share Hospital index, uncompensated care, essential community services, neighborhood disadvantage, and Sole Community Hospital and Critical Access Hospital status - and hospital operating margins. Includes information on the relationship between bed count, Census region, urban/rural location, ownership status, and having a Graduate Medical Education residency program with operating margins.
Author(s): Lukas K. Gaffney, Kenneth A. Michelson
Citation: JAMA Network Open, 6(4), e238785
Date: 04/2023
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Better Together: Rural Hospital High-Value Networks
Examines how rural hospital high-value networks can create economies of scale and value-based care capacity in order to enter into value-based payment contracts.
Author(s): Clint MacKinney, Nate White, Brett Norell
Citation: Rural Monitor
Date: 04/2023
Sponsoring organization: Rural Health Information Hub
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Last Updated: 4/15/2025