Rural Health
Resources by Topic: Critical Access Hospitals
Strategies for Critical Access Hospital Financial and Operational Performance Improvement: A Systematic Review
Summarizes findings from a systematic review of peer-reviewed and grey literature published since 2000 regarding financial and operational performance improvement interventions implemented by Critical Access Hospitals (CAHs) and rural hospitals in the United States and in other developed countries. Identifies key intervention areas, including service line optimization, revenue and cost management, and technology adoption, among others. Describes how State Flex Programs and hospital administrators can use these findings to inform decision-making and resource allocation.
Author(s): Angelina Budko, Laura Bozovich McFadyen, Carrie Baldwin-SoRelle, et al.
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Summarizes findings from a systematic review of peer-reviewed and grey literature published since 2000 regarding financial and operational performance improvement interventions implemented by Critical Access Hospitals (CAHs) and rural hospitals in the United States and in other developed countries. Identifies key intervention areas, including service line optimization, revenue and cost management, and technology adoption, among others. Describes how State Flex Programs and hospital administrators can use these findings to inform decision-making and resource allocation.
Author(s): Angelina Budko, Laura Bozovich McFadyen, Carrie Baldwin-SoRelle, et al.
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Trends in Inpatient Revenue and Volume Among Critical Access Hospitals
Examines trends in Critical Access Hospital (CAH) revenue and volume between 2017 and 2024. Presents data on average outpatient-to-total revenue and mean average daily census among CAHs each year by CAH urban or rural location, region, profit status, and system affiliation.
Author(s): Tyler Malone, Angelina Budko
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Examines trends in Critical Access Hospital (CAH) revenue and volume between 2017 and 2024. Presents data on average outpatient-to-total revenue and mean average daily census among CAHs each year by CAH urban or rural location, region, profit status, and system affiliation.
Author(s): Tyler Malone, Angelina Budko
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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A Chartbook on the Characteristics and Needs of Frontier Critical Access Hospitals
Summarizes findings from a 2025 national survey of executives from 117 Critical Access Hospitals (CAHs) in frontier counties. Includes data on the distribution and characteristics of frontier CAHs. Identifies themes related to financial and operational challenges, service availability, and access to care in frontier settings.
Author(s): John A. Gale, Rebecca Stearns, Zachariah Croll, Jayne Foley
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Summarizes findings from a 2025 national survey of executives from 117 Critical Access Hospitals (CAHs) in frontier counties. Includes data on the distribution and characteristics of frontier CAHs. Identifies themes related to financial and operational challenges, service availability, and access to care in frontier settings.
Author(s): John A. Gale, Rebecca Stearns, Zachariah Croll, Jayne Foley
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Location of Critical Access Hospitals
U.S. map showing Critical Access Hospitals (CAHs). Updated quarterly.
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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U.S. map showing Critical Access Hospitals (CAHs). Updated quarterly.
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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National Health Service Corps Site Reference Guide
Provides clarification for National Health Service Corps (NHSC) sites regarding eligibility requirements, qualification factors, compliance, roles and responsibilities, and other factors for becoming an NHSC approved site. Acts as a supplemental resource to the information provided in the online NHSC Site Application.
Date: 04/2026
Sponsoring organization: Health Resources and Services Administration
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Provides clarification for National Health Service Corps (NHSC) sites regarding eligibility requirements, qualification factors, compliance, roles and responsibilities, and other factors for becoming an NHSC approved site. Acts as a supplemental resource to the information provided in the online NHSC Site Application.
Date: 04/2026
Sponsoring organization: Health Resources and Services Administration
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Characterizing Early Adopters of the Rural Emergency Hospital Designation
Compares 42 hospitals that have received Rural Emergency Hospital (REH) designations to the 447 REH-eligible hospitals that have not converted to identify characteristics of early converters. Characteristics evaluated include Critical Access Hospital status, ownership and affiliations, healthcare utilization, staffing, available services, and finances.
Author(s): Jonah M. Graves, R.J. Waken, Fengxian Wang, Paula Chatterjee, Karen E. Joynt Maddox
Citation: Health Affairs Scholar, 4(3)
Date: 03/2026
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Compares 42 hospitals that have received Rural Emergency Hospital (REH) designations to the 447 REH-eligible hospitals that have not converted to identify characteristics of early converters. Characteristics evaluated include Critical Access Hospital status, ownership and affiliations, healthcare utilization, staffing, available services, and finances.
Author(s): Jonah M. Graves, R.J. Waken, Fengxian Wang, Paula Chatterjee, Karen E. Joynt Maddox
Citation: Health Affairs Scholar, 4(3)
Date: 03/2026
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An Examination of All-Payer Inpatient Rural Hospital Bypass
Examines the extent to which rural patients bypassed their nearest rural hospital for inpatient care in eight states. Analyzes data on inpatient hospital admissions for rural residents of these states using the 2018 Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SID). Identifies factors associated with hospital-level bypass rates by patient and hospital characteristics.
Author(s): Craig D. Holden, Shena Popat, Alana Knudson, Marilyn G. Klug
Date: 03/2026
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Examines the extent to which rural patients bypassed their nearest rural hospital for inpatient care in eight states. Analyzes data on inpatient hospital admissions for rural residents of these states using the 2018 Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SID). Identifies factors associated with hospital-level bypass rates by patient and hospital characteristics.
Author(s): Craig D. Holden, Shena Popat, Alana Knudson, Marilyn G. Klug
Date: 03/2026
Sponsoring organization: ETSU/NORC Rural Health Research Center
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MedPAC Report to the Congress: Medicare Payment Policy: Skilled Nursing Facility Services: Chapter 7
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 2024.
Date: 03/2026
Sponsoring organization: Medicare Payment Advisory Commission
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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 2024.
Date: 03/2026
Sponsoring organization: Medicare Payment Advisory Commission
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From Closure to Comeback: A Rural ICU Is Reborn
A podcast episode examining how rural hospitals can utilize technology and partnerships to provide local healthcare access to residents. Provides a discussion between CEOs of hospitals focusing on the reopening of an intensive care unit (ICU) at a Critical Access Hospital (CAH).
Author(s): Tom Haederle, Marc Boom, Mark Boucot
Date: 03/2026
Sponsoring organization: American Hospital Association
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A podcast episode examining how rural hospitals can utilize technology and partnerships to provide local healthcare access to residents. Provides a discussion between CEOs of hospitals focusing on the reopening of an intensive care unit (ICU) at a Critical Access Hospital (CAH).
Author(s): Tom Haederle, Marc Boom, Mark Boucot
Date: 03/2026
Sponsoring organization: American Hospital Association
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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 2025 Assessment.
Author(s): Madeleine Pick, Robert Barclay, Megan Lahr
Date: 03/2026
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 2025 Assessment.
Author(s): Madeleine Pick, Robert Barclay, Megan Lahr
Date: 03/2026
Sponsoring organization: Flex Monitoring Team
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