Rural Health
Resources by Topic: Critical Access Hospitals
CAH Quality Inventory & Assessment - State Flex Program Resources
Provides ancillary materials related to the 2025 Critical Access Hospital (CAH) Quality Inventory & Assessment (Assessment) for State Flex Programs (SFPs). Includes resources on the background and components of the Assessment for State Flex Programs, a template email that State Flex Programs can use to send to CAHs regarding the Assessment, and instructions for State Flex Programs detailing how to use the Assessment Data Tool for 2024 Assessment.
Author(s): Megan Lahr, Robert Barclay, Madeleine Pick
Date: 08/2025
Sponsoring organization: Flex Monitoring Team
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Provides ancillary materials related to the 2025 Critical Access Hospital (CAH) Quality Inventory & Assessment (Assessment) for State Flex Programs (SFPs). Includes resources on the background and components of the Assessment for State Flex Programs, a template email that State Flex Programs can use to send to CAHs regarding the Assessment, and instructions for State Flex Programs detailing how to use the Assessment Data Tool for 2024 Assessment.
Author(s): Megan Lahr, Robert Barclay, Madeleine Pick
Date: 08/2025
Sponsoring organization: Flex Monitoring Team
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CAH Quality Inventory & Assessment Resources
Provides a list of resources for Critical Access Hospitals (CAHs) to use to complete the 2025 CAH Quality Inventory and Assessment (Assessment). Includes resources regarding the background and components of the Assessment and instructions for each question.
Author(s): Megan Lahr, Robert Barclay, Madeleine Pick
Date: 08/2025
Sponsoring organization: Flex Monitoring Team
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Provides a list of resources for Critical Access Hospitals (CAHs) to use to complete the 2025 CAH Quality Inventory and Assessment (Assessment). Includes resources regarding the background and components of the Assessment and instructions for each question.
Author(s): Megan Lahr, Robert Barclay, Madeleine Pick
Date: 08/2025
Sponsoring organization: Flex Monitoring Team
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HCAHPS Toolkit for Critical Access Hospitals
Designed to assist Critical Access Hospitals (CAHs) in reporting and utilizing Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data. Provides a detailed description of HCAHPS as a Medicare Beneficiary Quality Improvement Project (MBQIP) core measure, strategies for improving HCAHPS survey response rates, and answers to common HCAHPS questions. Offers recommendations for utilizing HCAHPS data reports from vendors and the Flex Monitoring Team (FMT) and improving HCAHPS scores.
Date: 08/2025
Sponsoring organization: Flex Monitoring Team
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Designed to assist Critical Access Hospitals (CAHs) in reporting and utilizing Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data. Provides a detailed description of HCAHPS as a Medicare Beneficiary Quality Improvement Project (MBQIP) core measure, strategies for improving HCAHPS survey response rates, and answers to common HCAHPS questions. Offers recommendations for utilizing HCAHPS data reports from vendors and the Flex Monitoring Team (FMT) and improving HCAHPS scores.
Date: 08/2025
Sponsoring organization: Flex Monitoring Team
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Electronic Public Health Reporting Among Non-Federal Acute Care Hospitals, 2024
Data brief examining public health reporting among acute care hospitals, including rural hospitals and Critical Access Hospitals (CAHs), in 2024 using data from the the 2024 American Hospital Association (AHA) Information Technology (IT) supplement. Presents data on the mean number of public health reporting types completed by hospital size, CAH status, rural/urban location, and independent/system affiliation. Describes challenges hospitals face with electronic public health reporting and electronic health information, such as lack of capacity to exchange electronically, interface issues, and differing vocabulary standards. Appendix Table A1 presents data on the methods used to submit data electronically across four data streams - immunization registry, syndromic surveillance, electronic lab reporting, and electronic case reporting - by hospital characteristics.
Date: 07/2025
Sponsoring organization: Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology
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Data brief examining public health reporting among acute care hospitals, including rural hospitals and Critical Access Hospitals (CAHs), in 2024 using data from the the 2024 American Hospital Association (AHA) Information Technology (IT) supplement. Presents data on the mean number of public health reporting types completed by hospital size, CAH status, rural/urban location, and independent/system affiliation. Describes challenges hospitals face with electronic public health reporting and electronic health information, such as lack of capacity to exchange electronically, interface issues, and differing vocabulary standards. Appendix Table A1 presents data on the methods used to submit data electronically across four data streams - immunization registry, syndromic surveillance, electronic lab reporting, and electronic case reporting - by hospital characteristics.
Date: 07/2025
Sponsoring organization: Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology
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Location of Critical Access Hospitals
U.S. map showing Critical Access Hospitals (CAHs). Updated quarterly.
Date: 07/2025
Sponsoring organization: Flex Monitoring Team
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U.S. map showing Critical Access Hospitals (CAHs). Updated quarterly.
Date: 07/2025
Sponsoring organization: Flex Monitoring Team
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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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MBQIP Quality Measures National Annual Report - 2023
Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2023. Presents data on the four Medicare Beneficiary Quality Improvement Project (MBQIP) domains: patient safety/inpatient, outpatient, patient engagement, and care transitions.
Author(s): Megan Lahr, Alyssa Furukawa, Madeleine Pick, Robert Barclay
Date: 06/2025
Sponsoring organization: Flex Monitoring Team
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Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2023. Presents data on the four Medicare Beneficiary Quality Improvement Project (MBQIP) domains: patient safety/inpatient, outpatient, patient engagement, and care transitions.
Author(s): Megan Lahr, Alyssa Furukawa, Madeleine Pick, Robert Barclay
Date: 06/2025
Sponsoring organization: Flex Monitoring Team
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CAHMPAS Technical Bulletin: Revised Benchmarks and Data Exclusion Rules
Describes a review of 12 Critical Access Hospital Measurement and Performance Assessment System (CAHMPAS) benchmarks to reflect current operating conditions. Details which benchmarks were revised, unchanged, discontinued, or added. Also discusses revisions to the data exclusion rules to improve data quality.
Author(s): Aditya R. Pillutla, Kristie W. Thompson, George Pink, Kristin L. Reiter
Date: 06/2025
Sponsoring organization: Flex Monitoring Team
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Describes a review of 12 Critical Access Hospital Measurement and Performance Assessment System (CAHMPAS) benchmarks to reflect current operating conditions. Details which benchmarks were revised, unchanged, discontinued, or added. Also discusses revisions to the data exclusion rules to improve data quality.
Author(s): Aditya R. Pillutla, Kristie W. Thompson, George Pink, Kristin L. Reiter
Date: 06/2025
Sponsoring organization: Flex Monitoring Team
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2025
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers proposed reforms to the physician fee schedule updates and the accuracy of relative payment rates; supplemental benefits in Medicare Advantage; home healthcare use among Medicare Advantage enrollees; Part D prescription drug plans for beneficiaries in fee-for-service Medicare and Medicare Advantage; Medicare beneficiaries in nursing homes; the inclusion of rural providers in current Medicare fee-for-service quality reporting programs; and recommendations related to reducing beneficiary cost sharing for outpatient services at Critical Access Hospitals. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers proposed reforms to the physician fee schedule updates and the accuracy of relative payment rates; supplemental benefits in Medicare Advantage; home healthcare use among Medicare Advantage enrollees; Part D prescription drug plans for beneficiaries in fee-for-service Medicare and Medicare Advantage; Medicare beneficiaries in nursing homes; the inclusion of rural providers in current Medicare fee-for-service quality reporting programs; and recommendations related to reducing beneficiary cost sharing for outpatient services at Critical Access Hospitals. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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CAH Financial Indicators Report: Summary of Indicator Medians by State
Presents state and national median values of 29 financial indicators included in the Critical Access Hospital Measurement and Performance Assessment System (CAHMPAS). Provides an overview of each measurement and reports median values by state. Indicators represent seven areas of financial performance: profitability, liquidity, capital structure, revenue, cost, utilization, and other.
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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Presents state and national median values of 29 financial indicators included in the Critical Access Hospital Measurement and Performance Assessment System (CAHMPAS). Provides an overview of each measurement and reports median values by state. Indicators represent seven areas of financial performance: profitability, liquidity, capital structure, revenue, cost, utilization, and other.
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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