Rural Hospitals – Resources
Selected recent or important resources focusing on Rural Hospitals.
Analysis: Hospitals and Health Systems Are Critical to Preserving Access to Care for Rural Communities
Provides information on how hospitals provide access to healthcare for rural communities, with a focus on hospital outpatient departments (HOPDs). Includes data related to rural physician practice acquisitions, rural outpatient visits to an HOPD, Medicaid eligibility, and more.
Date: 01/2024
Sponsoring organization: American Hospital Association
view details
Provides information on how hospitals provide access to healthcare for rural communities, with a focus on hospital outpatient departments (HOPDs). Includes data related to rural physician practice acquisitions, rural outpatient visits to an HOPD, Medicaid eligibility, and more.
Date: 01/2024
Sponsoring organization: American Hospital Association
view details
Hospital Financing: Volume Limits and Reporting Could Help Manage Risks of Expanding FHA's Mortgage Insurance Program
Describes the Federal Housing Administration's (FHA) Hospital Mortgage Insurance Program, which insures loans for capital improvements at hospitals; loans insured through the program between 2000 and 2022. Explores characteristics of hospitals ineligible for the program that may impact their financing options. Examines the potential effects and risks of extending Hospital Mortgage Insurance Program eligibility to currently ineligible hospital types on program participation risks. Offers recommendations to Congress if it decides to expand program eligibility to hospitals that primarily provide non-acute care services.
Additional links: Full Report
Date: 01/2024
Sponsoring organization: Government Accountability Office
view details
Describes the Federal Housing Administration's (FHA) Hospital Mortgage Insurance Program, which insures loans for capital improvements at hospitals; loans insured through the program between 2000 and 2022. Explores characteristics of hospitals ineligible for the program that may impact their financing options. Examines the potential effects and risks of extending Hospital Mortgage Insurance Program eligibility to currently ineligible hospital types on program participation risks. Offers recommendations to Congress if it decides to expand program eligibility to hospitals that primarily provide non-acute care services.
Additional links: Full Report
Date: 01/2024
Sponsoring organization: Government Accountability Office
view details
A Comparison of 2017-19 Uncompensated Care of Rural and Urban Hospitals by Net Patient Revenue, System Affiliation, and Ownership
Examines the association between uncompensated care and three factors - net patient revenue, system affiliation, and ownership - using Medicare Cost Report data from 2017-2019. Compares rates of uncompensated care as a percentage of operating expenses across Critical Access Hospitals (CAHs), rural prospective payment system (PPS) hospitals, and urban PPS hospitals.
Author(s): Emmaline Keesee, Susie Gurzenda, Kristie Thompson, George Pink
Date: 01/2024
Sponsoring organization: North Carolina Rural Health Research Program
view details
Examines the association between uncompensated care and three factors - net patient revenue, system affiliation, and ownership - using Medicare Cost Report data from 2017-2019. Compares rates of uncompensated care as a percentage of operating expenses across Critical Access Hospitals (CAHs), rural prospective payment system (PPS) hospitals, and urban PPS hospitals.
Author(s): Emmaline Keesee, Susie Gurzenda, Kristie Thompson, George Pink
Date: 01/2024
Sponsoring organization: North Carolina Rural Health Research Program
view details
Overall Hospital Quality Star Rating: Overview for Flex Programs, Critical Access Hospitals and Rural Stakeholders
Provides an overview of the Centers for Medicare and Medicaid Services (CMS) Overall Hospital Star Ratings posted on the CMS Care Compare website. Describes the methodology for the Overall Hospital Star Ratings, including information on measure selection, measure grouping, measure group scores and hospital scoring, and peer grouping and star rating assignment. Discusses the implications these ratings have on Critical Access Hospitals and other small rural hospitals.
Date: 2024
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
view details
Provides an overview of the Centers for Medicare and Medicaid Services (CMS) Overall Hospital Star Ratings posted on the CMS Care Compare website. Describes the methodology for the Overall Hospital Star Ratings, including information on measure selection, measure grouping, measure group scores and hospital scoring, and peer grouping and star rating assignment. Discusses the implications these ratings have on Critical Access Hospitals and other small rural hospitals.
Date: 2024
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
view details
A National Staffing Emergency in Rural Health Care
Podcast episode featuring a discussion with three rural hospital executives from Colorado, Wisconsin, and Michigan regarding workforce shortages in rural hospitals. Describes factors driving workforce challenges; recruitment, onboarding, and retention strategies; approaches to introducing healthcare careers to youth and the community; and the role of technology in meeting healthcare needs.
Date: 12/2023
Sponsoring organization: American Hospital Association
view details
Podcast episode featuring a discussion with three rural hospital executives from Colorado, Wisconsin, and Michigan regarding workforce shortages in rural hospitals. Describes factors driving workforce challenges; recruitment, onboarding, and retention strategies; approaches to introducing healthcare careers to youth and the community; and the role of technology in meeting healthcare needs.
Date: 12/2023
Sponsoring organization: American Hospital Association
view details
Medicare Advantage in Rural Areas: Implications for Hospital Sustainability
Explores the relationship between Medicare Advantage (MA) penetration levels in rural areas and acute care hospital financial distress and closure between 2008 and 2019. Analyzes data from Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases from 14 states to describe rural acute care hospitals with low and high MA penetration.
Author(s): Rachel Mosher Henke, Kathryn R. Fingar, Lan Liang, H. Joanna Jiang
Citation: American Journal of Managed Care, 29(11), 594–600
Date: 11/2023
view details
Explores the relationship between Medicare Advantage (MA) penetration levels in rural areas and acute care hospital financial distress and closure between 2008 and 2019. Analyzes data from Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases from 14 states to describe rural acute care hospitals with low and high MA penetration.
Author(s): Rachel Mosher Henke, Kathryn R. Fingar, Lan Liang, H. Joanna Jiang
Citation: American Journal of Managed Care, 29(11), 594–600
Date: 11/2023
view details
A Comparison of Non-Operating Revenue between Rural and Urban Hospitals
Compares the relative percentage and composition of non-operating revenue (NOR) among Critical Access Hospitals (CAHs), rural Prospective Payment System (R-PPS) hospitals, and urban Prospective Payment System (U-PPS) hospitals from 2011-2019. Describes how hospitals can use NOR to offset negative operating incomes. Presents data on the composition of NOR by hospital type and ownership.
Author(s): Ariana Pitcher, Ruoyu Zhang, Susie Gurzenda, George Pink, Kristin L. Reiter
Date: 11/2023
Sponsoring organization: Flex Monitoring Team
view details
Compares the relative percentage and composition of non-operating revenue (NOR) among Critical Access Hospitals (CAHs), rural Prospective Payment System (R-PPS) hospitals, and urban Prospective Payment System (U-PPS) hospitals from 2011-2019. Describes how hospitals can use NOR to offset negative operating incomes. Presents data on the composition of NOR by hospital type and ownership.
Author(s): Ariana Pitcher, Ruoyu Zhang, Susie Gurzenda, George Pink, Kristin L. Reiter
Date: 11/2023
Sponsoring organization: Flex Monitoring Team
view details
Pediatric Hospitalizations at Rural and Urban Teaching and Nonteaching Hospitals in the US, 2009-2019
Describes changes in the number and proportion of pediatric hospitalizations and costs at urban teaching, urban nonteaching, and rural hospitals versus freestanding children's hospitals from 2009-2019. Estimates the number and proportion of hospitals providing inpatient pediatric care and characterizes changes in clinical complexity. Features statistics including sociodemographic, clinical, and hospital characteristics of pediatric hospitalizations, with breakdowns by urban and rural location.
Author(s): JoAnna K. Leyenaar, Seneca D. Freyleue, Mary Arakelyan, David C. Goodman, A. James O'Malley
Citation: JAMA Network Open, 6(9)
Date: 09/2023
view details
Describes changes in the number and proportion of pediatric hospitalizations and costs at urban teaching, urban nonteaching, and rural hospitals versus freestanding children's hospitals from 2009-2019. Estimates the number and proportion of hospitals providing inpatient pediatric care and characterizes changes in clinical complexity. Features statistics including sociodemographic, clinical, and hospital characteristics of pediatric hospitalizations, with breakdowns by urban and rural location.
Author(s): JoAnna K. Leyenaar, Seneca D. Freyleue, Mary Arakelyan, David C. Goodman, A. James O'Malley
Citation: JAMA Network Open, 6(9)
Date: 09/2023
view details
The Path to Follow When You Can't Go It Alone
Podcast episode featuring a discussion of hospital mergers, acquisitions, and affiliations with three rural hospital executives and leaders. Describes how rural hospitals can leverage partnerships to maintain and expand care in their communities.
Date: 08/2023
Sponsoring organization: American Hospital Association
view details
Podcast episode featuring a discussion of hospital mergers, acquisitions, and affiliations with three rural hospital executives and leaders. Describes how rural hospitals can leverage partnerships to maintain and expand care in their communities.
Date: 08/2023
Sponsoring organization: American Hospital Association
view details
Ownership of Hospitals: An Analysis of Newly-Released Federal Data & A Method for Assessing Common Owners
Analyzes Centers for Medicare & Medicaid Services (CMS) data on the ownership of all U.S. hospitals enrolled in Medicare. Presents data by hospital characteristics, including hospital type, rural and urban location, organizational structure; organizational owners and hospital chains; and individual owners.
Author(s): W. Pete Welch, Lanlan Xu, Nancy De Lew, Benjamin D. Sommers
Date: 08/2023
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
view details
Analyzes Centers for Medicare & Medicaid Services (CMS) data on the ownership of all U.S. hospitals enrolled in Medicare. Presents data by hospital characteristics, including hospital type, rural and urban location, organizational structure; organizational owners and hospital chains; and individual owners.
Author(s): W. Pete Welch, Lanlan Xu, Nancy De Lew, Benjamin D. Sommers
Date: 08/2023
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
view details
Additional resources are available related to this guide. See the full list of resources by topic for:
Last Updated: 2/2/2026