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Rural Health Information Hub

Rural Health
Resources by Topic: Critical Access Hospitals

Characteristics and Trends of Critical Access Hospitals That Own or Operate Ambulance Services
Explores trends in the number of Critical Access Hospital (CAH)-based ambulance services between 2017 and 2022. Analyzes Medicare Cost Report data to compare the characteristics of of CAHs that own and operate ambulance services to CAHs that do not. Presents findings from interviews with eight CAH-based ambulance services regarding the challenges of operating these services, including workforce recruitment and retention issues, the role of partnerships and community involvement, and lessons learned.
Author(s): John Gale, Karen Pearson, Rebecca Stearns, Zachariah Croll
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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2024 National CAH Quality Inventory & Assessment National Report
Presents a high-level summary of key data points from the September-November 2024 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; median swing bed admissions and swing bed length of stay; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; and CAH quality payment model participation.
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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Merit-Based Incentive Payment System (MIPS): 2025 Reporting MIPS Quality Measures through Medicare Part B Claims Quick Start Guide for Small Practices
Provides details on how small practices can report quality measures through Medicare Part B claims measures. Highlights changes to these measures in 2025, score redistribution policies for small practices, and information for clinicians at Critical Access Hospitals.
Date: 04/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Location of Critical Access Hospitals
U.S. map showing Critical Access Hospitals (CAHs). Updated quarterly.
Date: 04/2025
Sponsoring organization: Flex Monitoring Team
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MedPAC Report to the Congress: Medicare Payment Policy: Skilled Nursing Facility Services: Chapter 6
Discusses payment adequacy for skilled nursing facility (SNF) services. Features statistics on SNF care provided by rural hospitals and Critical Access Hospitals (CAHs) via swing beds and Medicare margins for urban, rural, and frontier freestanding SNFs in 2023.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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March 2025 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2025 meeting. Covers research and proposals related to reforming physician fee schedule updates and improving the accuracy of relative payment rates, reducing beneficiary cost-sharing for outpatient services at Critical Access Hospitals, Medicare insurance agents, Medigap, payment for ground ambulance services, home healthcare use among Medicare Advantage enrollees, and institutional special needs plans. Includes rural references and considerations throughout.
Additional links: Mandated Report: Payment for Ground Ambulance Services, Reducing Beneficiary Cost-Sharing for Outpatient Services at Critical Access Hospitals
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Quality Improvement Workbook
Outlines seven steps of the quality improvement process. Offers interactive worksheets to help Critical Access Hospitals develop and support quality improvement goals and projects.
Date: 03/2025
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
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MBQIP 2025 Measure Core Set Information Guide
Provides an overview of the 2025 Core Measure Set adopted by the Federal Office of Rural Health Policy (FORHP) for use in the Medicare Beneficiary Quality Improvement Project (MBQIP). Offers descriptions, rationales, data elements, data availability, resources, and more for each new and continuing measure.
Date: 03/2025
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
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February 2025 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) February 2025 meeting. Covers transitions of care for children and youth with special healthcare needs (CYSHCN), hospital non-disproportionate share hospital supplemental payments and directed payment targeting, improving access to medications for opioid use disorder, healthcare access for children in foster care, and more. Includes rural references throughout.
Additional links: Hospital Non-DSH Supplemental Payment and Directed Payment Targeting Analyses
Date: 02/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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North Carolina Rural Hospital Program: 2024 Profile
Fact sheet with North Carolina rural hospital-related statistics on grants, return on investment and economic impact, technical assistance, and total program funding. Includes a county-level map showing locations of Critical Access Hospitals and small rural hospitals.
Date: 02/2025
Sponsoring organization: North Carolina Department of Health and Human Services
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