Rural Hospitals – Resources
Selected recent or important resources focusing on Rural Hospitals.
Obstetric Care Access Declined in Rural and Urban Hospitals Across US States, 2010–22
Examines the number and proportion of hospitals located in rural and urban counties in each state that lost hospital-based obstetric services between 2010 and 2022. Describes the proportion of hospitals without obstetric services for any reason by 2022.
Author(s): Katy Backes Kozhimannil, Julia D. Interrante, Caitlin Carroll, et al.
Citation: Health Affairs, 44(7), 806-811
Date: 07/2025
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Examines the number and proportion of hospitals located in rural and urban counties in each state that lost hospital-based obstetric services between 2010 and 2022. Describes the proportion of hospitals without obstetric services for any reason by 2022.
Author(s): Katy Backes Kozhimannil, Julia D. Interrante, Caitlin Carroll, et al.
Citation: Health Affairs, 44(7), 806-811
Date: 07/2025
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Emergency Department Visits among Rural and Urban Older Adults: Disparities in Ambulatory and Emergency Care Sensitive Conditions
Compares emergency department (ED) utilization for ambulatory care sensitive conditions (ACSCs) and emergency care sensitive conditions (ECSCs) among rural and urban Medicare beneficiaries. Presents findings from a pooled cross-sectional analysis of 2016–2020 Medicare Current Beneficiary Survey data.
Author(s): Cameron J. Gettel, Courtney Kitchen, Craig Rothenberg, et al.
Citation: BMC Health Services Research, 25, 275
Date: 07/2025
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Compares emergency department (ED) utilization for ambulatory care sensitive conditions (ACSCs) and emergency care sensitive conditions (ECSCs) among rural and urban Medicare beneficiaries. Presents findings from a pooled cross-sectional analysis of 2016–2020 Medicare Current Beneficiary Survey data.
Author(s): Cameron J. Gettel, Courtney Kitchen, Craig Rothenberg, et al.
Citation: BMC Health Services Research, 25, 275
Date: 07/2025
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Variation, Overlap, and Stability in Defining Safety Net Hospitals
Results of a study examining the extent to which safety net hospitals overlap, change over time, and represent similar types of healthcare facilities. Features statistics with breakdowns including rural location and Critical Access Hospital designation.
Author(s): Paula Chatterjee, Joshua M. Liao, Kano Amagai, et al.
Citation: JAMA Network Open, 8(7), e2523923
Date: 07/2025
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Results of a study examining the extent to which safety net hospitals overlap, change over time, and represent similar types of healthcare facilities. Features statistics with breakdowns including rural location and Critical Access Hospital designation.
Author(s): Paula Chatterjee, Joshua M. Liao, Kano Amagai, et al.
Citation: JAMA Network Open, 8(7), e2523923
Date: 07/2025
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The Impact of Rural Hospital Closures and Mergers on Health System Ecologies: A Scoping Review
Examines 46 studies on rural hospital closures and mergers between 2010 to 2023, with a focus on understanding health system impacts, finances, workforce, utilization, access to facilities and services, and community and economic well-being.
Author(s): Alison Coates, Janice Probst, Kanika Sarwal, Suhaib Riaz, Agnes Grudniewicz
Citation: Medical Care Research and Review, 82(5)
Date: 07/2025
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Examines 46 studies on rural hospital closures and mergers between 2010 to 2023, with a focus on understanding health system impacts, finances, workforce, utilization, access to facilities and services, and community and economic well-being.
Author(s): Alison Coates, Janice Probst, Kanika Sarwal, Suhaib Riaz, Agnes Grudniewicz
Citation: Medical Care Research and Review, 82(5)
Date: 07/2025
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AHEAD CMS-Designed Medicare FFS HGB Calculator Tool for Acute Care Hospitals Demonstration
Provides an overview and demonstration of the CMS-Designed Medicare Fee-for-Service Hospital Global Budget (HGB) Calculator Tool, which aims to support fee-for-service acute care hospitals in understanding the HGB financial methodology for the AHEAD Model. Discusses how an AHEAD Medicare Fee-for-Service Hospital Global Budget is constructed.
Additional links: AHEAD Model CMS-Designed Medicare FFS Acute Care Hospital Global Budget Calculator Tool, AHEAD Model: CMS-Designed Medicare Hospital Global Budget Acute Care Hospital Calculator Tool At-A-Glance
Date: 07/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Provides an overview and demonstration of the CMS-Designed Medicare Fee-for-Service Hospital Global Budget (HGB) Calculator Tool, which aims to support fee-for-service acute care hospitals in understanding the HGB financial methodology for the AHEAD Model. Discusses how an AHEAD Medicare Fee-for-Service Hospital Global Budget is constructed.
Additional links: AHEAD Model CMS-Designed Medicare FFS Acute Care Hospital Global Budget Calculator Tool, AHEAD Model: CMS-Designed Medicare Hospital Global Budget Acute Care Hospital Calculator Tool At-A-Glance
Date: 07/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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FY 2026 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule — CMS-1833-F
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2026 hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Includes information about the Medicare Promoting Interoperability Program and the discontinuation of the low-wage index hospital policy for FY 2026 and subsequent years.
Date: 07/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2026 hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Includes information about the Medicare Promoting Interoperability Program and the discontinuation of the low-wage index hospital policy for FY 2026 and subsequent years.
Date: 07/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Effects of Using Different Rural Measurements on Estimates of Hospitalizations for Depression and Substance Use
Explores how using different rural measurements can affect estimates of hospitalization rates for behavioral health conditions. Highlights how Rural-Urban Commuting Areas (RUCA) codes, Core-Based Statistical Areas (CBSA), Urban-Rural Category 4 (URCategory4), and Rural-Urban Continuum Codes (RUCC) affect hospitalization estimates. Discusses the consequences these difference can have on policy.
Author(s): Robin Danek, Justin Blackburn, Marion Greene, et al.
Citation: BMC Health Services Research, 25, 818
Date: 06/2025
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Explores how using different rural measurements can affect estimates of hospitalization rates for behavioral health conditions. Highlights how Rural-Urban Commuting Areas (RUCA) codes, Core-Based Statistical Areas (CBSA), Urban-Rural Category 4 (URCategory4), and Rural-Urban Continuum Codes (RUCC) affect hospitalization estimates. Discusses the consequences these difference can have on policy.
Author(s): Robin Danek, Justin Blackburn, Marion Greene, et al.
Citation: BMC Health Services Research, 25, 818
Date: 06/2025
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The Impact of High Hospital Fixed-Cost Ratios on Rural Populations
Explores how rurality relates to hospital cost structures as categorized by Urban Influence Codes (UICs). Describes the characteristics of hospitals at different fixed-to-total-cost ratio levels, the demographics associated with hospitals at different ratio levels, and the share of nonmetropolitan hospitals that have Critical Access Hospital (CAH) or Low-Volume Hospital (LVH) designations. Discusses how findings could be used to refine hospital payment policies.
Author(s): Abigail Barker, Eliot Jost, Timothy McBride, Keith Mueller
Date: 06/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Explores how rurality relates to hospital cost structures as categorized by Urban Influence Codes (UICs). Describes the characteristics of hospitals at different fixed-to-total-cost ratio levels, the demographics associated with hospitals at different ratio levels, and the share of nonmetropolitan hospitals that have Critical Access Hospital (CAH) or Low-Volume Hospital (LVH) designations. Discusses how findings could be used to refine hospital payment policies.
Author(s): Abigail Barker, Eliot Jost, Timothy McBride, Keith Mueller
Date: 06/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Preventing Medical Debt among Rural Residents: Example Programs from Hospitals in Minnesota and Montana
Highlights the ways some rural hospitals are working to reduce medical debt for their patients. Presents a number of strategies from hospitals in Minnesota and Montana that aim to reduce patient medical debts through financial assistance programs and cost-cutting measures. Features case-studies reviewing the structure of each hospital's debt reduction efforts.
Author(s): Katie Rydberg, Sushma Shankar, Mariana Tuttle, Carrie Henning-Smith
Date: 06/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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Highlights the ways some rural hospitals are working to reduce medical debt for their patients. Presents a number of strategies from hospitals in Minnesota and Montana that aim to reduce patient medical debts through financial assistance programs and cost-cutting measures. Features case-studies reviewing the structure of each hospital's debt reduction efforts.
Author(s): Katie Rydberg, Sushma Shankar, Mariana Tuttle, Carrie Henning-Smith
Date: 06/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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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, 60(3), e14426
Date: 06/2025
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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, 60(3), e14426
Date: 06/2025
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