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Rural Health Information Hub

Rural Hospitals – Resources

Selected recent or important resources focusing on Rural Hospitals.

Caitlin Carroll on Rural Hospital Survival
A podcast episode featuring Caitlin Carroll of the University of Minnesota's School of Public Health. Discusses the financial challenges rural hospitals face and common paths for unprofitable hospitals - continuing as-is, closure, or merging with another hospital system.
Date: 04/2023
Sponsoring organization: Health Affairs
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In Need of a Checkup: Examining the Cybersecurity Risks to the Healthcare Sector
Recording of a March 16, 2023, U.S. Senate Committee on Homeland Security and Governmental Affairs hearing on cybersecurity threats facing the healthcare sector. Features testimony from Kate Pierce, the former Chief Information Officer and Chief Information Security Officer of an Alabama Critical Access Hospital, who discusses cybersecurity in small and rural hospitals.
Additional links: Kate Piece, Fortified Health Security - Testimony
Date: 03/2023
Sponsoring organization: Senate Committee on Homeland Security and Governmental Affairs
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Emergency Department Visits Related to Mental Health Disorders Among Adults, by Race and Hispanic Ethnicity: United States, 2018–2020
Report explores the rates of mental health-related visits to emergency departments (EDs) by race and Hispanic ethnicity. Breaks down data by race, mental health disorder, and urbanization level, among other measures.
Author(s): Zachary J. Peters, Loredana Santo, Danielle Davis, Carol J. DeFrances
Date: 03/2023
Sponsoring organization: National Center for Health Statistics
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Availability of Hospital-Based Cancer Services Before and After Rural Hospital Closure, 2008–2017
Explores the effect rural hospital closures have had on rural cancer care. Draws from American Hospital Association data from 2008 to 2017 and explores the differing outcomes hospital closures had on oncology care, radiation services, and cancer screening in rural areas.
Author(s): Whitney E. Zahnd, Peiyin Hung, Sylvia Kewei Shi, et al.
Citation: Journal of Rural Health, 39(2), 416-425
Date: 03/2023
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Rural Hospitals Face Renewed Financial Challenges, Especially in States That Have Not Expanded Medicaid
Provides an overview of rural hospital finances before the COVID-19 pandemic and compares operating margins in hospitals in states that expanded Medicaid with those that did not expand Medicaid. Describes financial trends during pandemic. Highlights selected policy initiatives intended to support rural hospitals or restructure the rural healthcare delivery system.
Author(s): Zachary Levinson, Jamie Godwin, Scott Hulver
Date: 02/2023
Sponsoring organization: KFF
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Community Sociodemographics and Rural Hospital Survival Analysis
Policy brief highlights the specific sociodemographic characteristics of rural communities that correlate with hospitals that are in financial distress. Examines the community factors for 985 rural hospitals in financial distress according to the Financial Distress Index from 2010 to 2019.
Author(s): Claudia A. Rhoades, Brian E. Whitacre, Alison F. Davis
Date: 01/2023
Sponsoring organization: Center for Economic Analysis of Rural Health
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Changes in Service Offerings Post-System Affiliation in Rural Hospitals
Explores the effects of joining or leaving a regional or national healthcare system on 62 service offerings at rural prospective payment system (PPS) hospitals and Critical Access Hospitals (CAHs) between 2008 through 2020. Compares services offered at hospitals that joined a system, left a system, were always in a system during the study period, and were never is a system during the study period.
Date: 01/2023
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Community Sociodemographics and Rural Hospital Survival
Explores differences in specific community-level sociodemographic factors associated with the survival or closure of rural hospitals at risk of financial distress between 2010 and 2019. Examines the relationship between the risk of hospital closure and median family income, unemployment rate, uninsured rate, education, race, and more.
Author(s): Claudia A. Rhoades, Brian E. Whitacre, Alison F. Davis
Citation: Journal of Rural Health, 2023(39), 643-655
Date: 2023
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Evaluation of the Rural Community Hospital Demonstration: Interim Report Two (Covering 2016-2018)
Provides an overview of the Rural Community Hospital Demonstration (RCHD). Describes the characteristics of RCHD participants as of fiscal year 2018, the Medicare payments received under the program, and the impact of the RCHD on hospital financial measures. Examines whether hospitals that continued to participate in the RCHD under the 21st Century Cures Act (CCA) extension experienced additional changes to their financial condition, as well as the impact of the program on hospitals that joined the demonstration for the first time under the CCA extension.
Additional links: Findings at a Glance
Date: 12/2022
Sponsoring organizations: American Institutes for Research, Centers for Medicare and Medicaid Services
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The Evolution of Hospital Designations and Payment in the U.S.: Implications for Rural Hospitals
Provides a history and overview of Medicare hospital payment polices as well as alternative payment models and their impact on rural facilities. Discusses the context in which rural hospitals serve patients, rural hospital payment provisions and designations, and current federal payment models that impact rural hospitals.
Author(s): Onyinye Oyeka, Clinton MacKinney, Keith J. Mueller
Date: 12/2022
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Last Updated: 4/7/2025