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Rural Health
Resources by Topic: Closures of healthcare facilities and services

Rural Communities at Risk: Widening Health Disparities Present New Challenges in Aftermath of Pandemic
Describes the health status, health disparities, and socioeconomic disparities of vulnerable rural communities. Analyzes the relationship between rural community vulnerability and the stability of the rural health safety net. Includes information on racial health disparities within rural communities.
Date: 07/2021
Type: Document
Sponsoring organization: The Chartis Group
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Access to Affordable Care in Rural America: Current Trends and Key Challenges
Describes geographic and demographic challenges that contribute to healthcare access and health disparities in rural areas. Covers patterns of insurance coverage between rural and urban areas, healthcare provider shortages, and rural hospital vulnerability and closures. Discusses programs and services supported by the U.S. Department of Health and Human Services (HHS) to reduce barriers to care in rural communities, including telehealth, healthcare workforce programs, and Rural Health Clinics and community health centers.
Author(s): Gina Turrini, D.Keith Branham, Lucy Chen, et al.
Date: 07/2021
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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How Many Hospitals Might Convert to a Rural Emergency Hospital (REH)?
Results of a study to predict the number of rural hospitals with 50 beds or fewer that are likely to consider conversion to Rural Emergency Hospital designation under the Medicare program. Features statistics on number and percent of complete closures and converted closures between 2011-2020 among hospitals with 50 beds or fewer, and open hospitals as of 2019-2020, with breakdowns by financial measures, operational measures, Medicare payment type, and census division.
Author(s): George H. Pink, Kristie W. Thompson, H. Ann Howard, G. Mark Holmes
Date: 07/2021
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2021
Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Chapter 5 presents an interim report on Medicare beneficiaries' access to care in rural areas. Also includes chapters on Medicare Advantage benchmark policy, alternative payment models, private equity and Medicare, the skilled nursing facility value-based purchasing program, indirect medical education payments, Medicare coverage of vaccines, separately payable drugs in the hospital outpatient prospective payment system, clinical laboratory fee schedule payment rates, and the relationship between clinician services and other Medicare services.
Additional links: Executive Summary
Date: 06/2021
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Supporting and Sustaining Rural Hospitals
Describes state and federal actions to support and safeguard rural hospitals. Discusses appropriated funding opportunities for struggling hospitals, Medicaid coverage and eligibility, alternative payment models, and technical assistance programs.
Author(s): Noah Cruz
Date: 04/2021
Type: Document
Sponsoring organization: National Conference of State Legislatures
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Place and Population Matter in General Surgeon Location and Practice Structure
Examines ways in which population changes over time in different geographical regions of the United States have affected the availability of general surgeons and quality of care. Explores the implications of hospital mergers on the viability of rural hospitals.
Author(s): Thomas C. Ricketts
Citation: JAMA Network Open, 4(4)
Date: 04/2021
Type: Document
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Changes in Provision of Selected Services by Rural and Urban Hospitals between 2009 and 2017
Examines the increase in number of rural hospitals that have closed or converted to a model eliminating inpatient care, as well as rural hospitals that have reduced or terminated historically essential services including obstetrics, surgery, long-term care, home health, and oncology. Features statistics on the number of hospitals offering various types of healthcare services in 2009 and in 2017, with breakdowns by urban and rural location.
Author(s): Kathleen Knocke, George H. Pink, Kristie W. Thompson, Randy K. Randolph, Mark Holmes
Date: 04/2021
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Rural and Urban Hospital Characteristics by Obstetric Service Provision Status, 2010-2018
Illustrates the differences between urban and rural hospitals providing obstetric (OB) services. Compares them by size, capacity, location, and community characteristics, and compares these factors between rural hospitals with OB units and those that had discontinued services during the study period. Features statistics with breakdowns by urban and rural location.
Additional links: Characteristics of Rural and Urban U.S. Hospitals Based on Obstetric Services
Author(s): Julia D. Interrante, Lindsay K. Admon, Mariana S. Tuttle, Bridget Basile Ibrahim, Katy B. Kozhimannil
Date: 04/2021
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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States Work to Support Rural Hospitals Despite Pandemic Challenges
Blog post highlighting state-level policies to address and prevent rural hospital closures. Discusses proposals in state legislatures regarding alternative payment methodologies and funding, service delivery models, and the recruitment and retention of a rural healthcare workforce.
Author(s): Beth Giambrone
Date: 04/2021
Type: Document
Sponsoring organization: Association of State and Territorial Health Officials
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Rural Obstetric Unit Closures and Maternal and Infant Health
Policy paper examining the discontinuation of obstetric services in rural communities. Discusses factors contributing to obstetric unit closures, including hospital financial constraints, Medicaid reimbursement rates, and maternal health workforce concerns. Offers policy recommendations to prevent additional obstetric unit closures in rural areas.
Author(s): Lindsay Corcoran, Catherine Clary, Sarah Brinkman
Date: 02/2021
Type: Document
Sponsoring organization: National Rural Health Association
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