Rural Health
Resources by Topic: Critical Access Hospitals
RHCs, FQHCs, Tribal Clinics and CAHs in Rural Oregon
Shows a county-level map of Oregon identifying the Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), tribal clinics, and Critical Access Hospitals (CAHs). Highlights rural, urban, and frontier areas.
Date: 01/2025
Sponsoring organization: Oregon Office of Rural Health
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Shows a county-level map of Oregon identifying the Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), tribal clinics, and Critical Access Hospitals (CAHs). Highlights rural, urban, and frontier areas.
Date: 01/2025
Sponsoring organization: Oregon Office of Rural Health
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South Dakota Critical Access Hospitals
County-level map of South Dakota showing locations of Critical Access Hospitals (CAHs).
Date: 01/2025
Sponsoring organization: South Dakota Office of Rural Health
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County-level map of South Dakota showing locations of Critical Access Hospitals (CAHs).
Date: 01/2025
Sponsoring organization: South Dakota Office of Rural Health
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The University of Arizona Center for Rural Health Annual Report FY 2024-2025
Highlights the Center for Rural Health's past-year accomplishments, and describes challenges and opportunities for improving the health of rural Arizonans in the upcoming year. Discusses the State Office of Rural Health, Arizona Health Improvement Plan (AzHIP), Arizona Rural Hospital Flexibility program (AzFLEX), Arizona Small Rural Hospital Improvement Program (AzSHIP), and other programs. Includes a map of rural and safety net health facilities.
Date: 2025
Sponsoring organization: Arizona Center for Rural Health
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Highlights the Center for Rural Health's past-year accomplishments, and describes challenges and opportunities for improving the health of rural Arizonans in the upcoming year. Discusses the State Office of Rural Health, Arizona Health Improvement Plan (AzHIP), Arizona Rural Hospital Flexibility program (AzFLEX), Arizona Small Rural Hospital Improvement Program (AzSHIP), and other programs. Includes a map of rural and safety net health facilities.
Date: 2025
Sponsoring organization: Arizona Center for Rural Health
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Financial Performance Gaps Between Critical Access Hospitals and Other Acute Care Hospitals
Research letter examining how system affiliation impacted hospital financial measures for Critical Access Hospitals (CAHs) and non-CAHs between 2020 and 2022.
Author(s): Christopher Whaley, Marilyn Bartlett, Ge Bai
Citation: JAMA Health Forum, 5(12)
Date: 12/2024
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Research letter examining how system affiliation impacted hospital financial measures for Critical Access Hospitals (CAHs) and non-CAHs between 2020 and 2022.
Author(s): Christopher Whaley, Marilyn Bartlett, Ge Bai
Citation: JAMA Health Forum, 5(12)
Date: 12/2024
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Medicare Could save Billions with Comparable Access for Enrollees If Critical Access Hospital Payments for Swing-Bed Services Were Similar to Those of the Fee-for-Service Prospective Payment System
Describes the use of swing beds for skilled nursing services at Critical Access Hospitals (CAHs) and average daily Medicare reimbursement for these services from 2015 through 2020. Examines data from a sample of 100 CAHs to determine whether Medicare enrollees would have had access to the same skilled nursing services provided by CAHs at alternative facilities within a 35-mile driving distance. Compares the average daily reimbursement for skilled nursing services at CAHs and alternative facilities, as well as the potential savings to Medicare if CAHs were reimbursed for skilled nursing services under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS).
Date: 12/2024
Sponsoring organization: Office of Inspector General (HHS)
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Describes the use of swing beds for skilled nursing services at Critical Access Hospitals (CAHs) and average daily Medicare reimbursement for these services from 2015 through 2020. Examines data from a sample of 100 CAHs to determine whether Medicare enrollees would have had access to the same skilled nursing services provided by CAHs at alternative facilities within a 35-mile driving distance. Compares the average daily reimbursement for skilled nursing services at CAHs and alternative facilities, as well as the potential savings to Medicare if CAHs were reimbursed for skilled nursing services under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS).
Date: 12/2024
Sponsoring organization: Office of Inspector General (HHS)
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The Pennsylvania Rural Health Model (PARHM): Fourth Annual Evaluation Report
Evaluates the fourth performance year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall healthcare spending. Provides an overview of the model and describes the implementation experience of participating hospitals and payers. Presents a descriptive quantitative assessment of financial performance, spending and utilization, access to care, and quality of care outcomes from 2016, the model's baseline, through 2022. Includes three case studies discussing three themes: experiences with global budget reconciliation, behavioral health transformation, and interactions and alignment between PARHM and other value-based care programs.
Additional links: Appendix, Findings at a Glance
Date: 12/2024
Sponsoring organizations: Centers for Medicare & Medicaid Services, NORC at the University of Chicago
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Evaluates the fourth performance year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall healthcare spending. Provides an overview of the model and describes the implementation experience of participating hospitals and payers. Presents a descriptive quantitative assessment of financial performance, spending and utilization, access to care, and quality of care outcomes from 2016, the model's baseline, through 2022. Includes three case studies discussing three themes: experiences with global budget reconciliation, behavioral health transformation, and interactions and alignment between PARHM and other value-based care programs.
Additional links: Appendix, Findings at a Glance
Date: 12/2024
Sponsoring organizations: Centers for Medicare & Medicaid Services, NORC at the University of Chicago
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Hospital Margins Rebounded in 2023, But Rural Hospitals and Those With High Medicaid Shares Were Struggling More Than Others
Examines hospital margins for non-federal general short-term hospitals in the U.S. from 2018 through 2023, with a focus on operating margins. Analyzes RAND Hospital Data to explore the extent to which hospitals profited or lost money on patient care and other operating activities. Discusses differences in operating margins by hospital characteristics, including hospital ownership type, commercial share, size, rural or urban location, and Medicare rural payment designation.
Date: 12/2024
Sponsoring organization: KFF
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Examines hospital margins for non-federal general short-term hospitals in the U.S. from 2018 through 2023, with a focus on operating margins. Analyzes RAND Hospital Data to explore the extent to which hospitals profited or lost money on patient care and other operating activities. Discusses differences in operating margins by hospital characteristics, including hospital ownership type, commercial share, size, rural or urban location, and Medicare rural payment designation.
Date: 12/2024
Sponsoring organization: KFF
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Critical Access Hospital Financial Sustainability Guide
Provides guidance and assistance to state Medicare Rural Hospital Flexibility (Flex) Program personnel, leaders of Critical Access Hospitals (CAHs), and others helping CAHs manage long-term financial stability. Presents potential interventions CAHs may use to address ongoing and systemic financial challenges in rural healthcare.
Date: 12/2024
Sponsoring organizations: EideBailly, National Rural Health Resource Center
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Provides guidance and assistance to state Medicare Rural Hospital Flexibility (Flex) Program personnel, leaders of Critical Access Hospitals (CAHs), and others helping CAHs manage long-term financial stability. Presents potential interventions CAHs may use to address ongoing and systemic financial challenges in rural healthcare.
Date: 12/2024
Sponsoring organizations: EideBailly, National Rural Health Resource Center
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North Dakota Critical Access Hospital Conditions of Participation (CoP) Checklist
Provides a checklist for establishing a Critical Access Hospital (CAH) in North Dakota. Details the required documentation, policies, and information needed by the state survey team to meet the CAH certification standards.
Date: 11/2024
Sponsoring organization: University of North Dakota Center for Rural Health
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Provides a checklist for establishing a Critical Access Hospital (CAH) in North Dakota. Details the required documentation, policies, and information needed by the state survey team to meet the CAH certification standards.
Date: 11/2024
Sponsoring organization: University of North Dakota Center for Rural Health
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North Carolina SFY 2025 Safety Net Sites
County-level map showing locations of various healthcare facilities, including Rural Health Clinics, Critical Access Hospitals, small rural hospitals, and Federally Qualified Health Centers.
Date: 11/2024
Sponsoring organization: North Carolina Department of Health and Human Services
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County-level map showing locations of various healthcare facilities, including Rural Health Clinics, Critical Access Hospitals, small rural hospitals, and Federally Qualified Health Centers.
Date: 11/2024
Sponsoring organization: North Carolina Department of Health and Human Services
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