Rural Hospitals – Resources
Selected recent or important resources focusing on Rural Hospitals.
Early Impacts of the Pennsylvania Rural Health Model on Potentially Avoidable Utilization
Assesses the impact of the Pennsylvania Rural Health Model (PARHM) on potentially avoidable utilization rates between 2016 and 2022 by comparing participating and non-participating hospitals. Discusses the potential impact of COVID-19 on results.
Author(s): Donald S. Bourne, Eric T. Roberts, Lindsay M. Sabik
Citation: Health Affairs Scholar, 2(2)
Date: 02/2024
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Assesses the impact of the Pennsylvania Rural Health Model (PARHM) on potentially avoidable utilization rates between 2016 and 2022 by comparing participating and non-participating hospitals. Discusses the potential impact of COVID-19 on results.
Author(s): Donald S. Bourne, Eric T. Roberts, Lindsay M. Sabik
Citation: Health Affairs Scholar, 2(2)
Date: 02/2024
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The Effects of Medicare Advantage on Rural Hospitals With St. Bernards Healthcare
Podcast episode featuring a discussion with Chris Barber, president and CEO of St. Bernards Healthcare, which serves communities in Arkansas and Missouri. Describes how certain Medicare Advantage plan practices can create problems for rural hospitals, health systems, and patients.
Date: 01/2024
Sponsoring organization: American Hospital Association
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Podcast episode featuring a discussion with Chris Barber, president and CEO of St. Bernards Healthcare, which serves communities in Arkansas and Missouri. Describes how certain Medicare Advantage plan practices can create problems for rural hospitals, health systems, and patients.
Date: 01/2024
Sponsoring organization: American Hospital Association
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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
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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
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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
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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
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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
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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
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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
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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
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Rural America's OB Deserts Widen in Fallout From Pandemic
Explores the loss of obstetrics services in rural communities since 2011. Presents data on the number and percentage of rural hospitals that discontinued obstetrics services between 2011 and 2021. Discusses the impact of the loss of these services on maternal and infant health.
Date: 12/2023
Sponsoring organization: Chartis Center for Rural Health
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Explores the loss of obstetrics services in rural communities since 2011. Presents data on the number and percentage of rural hospitals that discontinued obstetrics services between 2011 and 2021. Discusses the impact of the loss of these services on maternal and infant health.
Date: 12/2023
Sponsoring organization: Chartis Center for Rural Health
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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
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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
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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
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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
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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
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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
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Last Updated: 2/12/2025