Rural Health
Resources by Topic: Critical Access Hospitals
Hospitals' Electronic Access to Information Needed to Treat COVID-19
Explores acute care hospitals' ability to access electronic access to information necessary to treat COVID-19 patients in 2021. Examines differences in information availability by hospital characteristics, including rurality and Critical Access Hospital (CAH) status, and engagement in interoperable exchange.
Author(s): Chelsea Richwine, Jordan Everson, Vaishali Patel
Citation: JAMIA Open, 6(4)
Date: 12/2023
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Explores acute care hospitals' ability to access electronic access to information necessary to treat COVID-19 patients in 2021. Examines differences in information availability by hospital characteristics, including rurality and Critical Access Hospital (CAH) status, and engagement in interoperable exchange.
Author(s): Chelsea Richwine, Jordan Everson, Vaishali Patel
Citation: JAMIA Open, 6(4)
Date: 12/2023
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A Comparison of Non-Operating Revenue between Rural and Urban Hospitals
Compares the relative percentage and composition of non-operating revenue (NOR) among Critical Access Hospitals (CAHs), rural Prospective Payment System (R-PPS) hospitals, and urban Prospective Payment System (U-PPS) hospitals from 2011-2019. Describes how hospitals can use NOR to offset negative operating incomes. Presents data on the composition of NOR by hospital type and ownership.
Author(s): Ariana Pitcher, Ruoyu Zhang, Susie Gurzenda, George Pink, Kristin L. Reiter
Date: 11/2023
Sponsoring organization: Flex Monitoring Team
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Compares the relative percentage and composition of non-operating revenue (NOR) among Critical Access Hospitals (CAHs), rural Prospective Payment System (R-PPS) hospitals, and urban Prospective Payment System (U-PPS) hospitals from 2011-2019. Describes how hospitals can use NOR to offset negative operating incomes. Presents data on the composition of NOR by hospital type and ownership.
Author(s): Ariana Pitcher, Ruoyu Zhang, Susie Gurzenda, George Pink, Kristin L. Reiter
Date: 11/2023
Sponsoring organization: Flex Monitoring Team
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Hospital Consumer Assessment of Healthcare Providers and Systems Overview: Vendor Directory
Provides information about the benefits and challenges of implementing a HCAHPS survey process in small rural hospitals, specifically Critical Access Hospitals (CAHs). Includes a full directory of vendors currently authorized to perform HCAHPS data collection.
Date: 11/2023
Sponsoring organization: National Rural Health Resource Center
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Provides information about the benefits and challenges of implementing a HCAHPS survey process in small rural hospitals, specifically Critical Access Hospitals (CAHs). Includes a full directory of vendors currently authorized to perform HCAHPS data collection.
Date: 11/2023
Sponsoring organization: National Rural Health Resource Center
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Performance Management/Program Evaluation Guide: Medicare Rural Hospital Flexibility (Flex) Program
Offers guidance to state Flex program coordinators to incorporate performance management and evaluation into Flex program operations as required by the Flex Program Cooperative Agreement. Supports the state's capacity for assessing program activities, making improvements, and establishing if activities are effective. Defines key terms and concepts, discusses reporting requirements, demonstrates a performance year work plan, covers data collection, and provides examples of goals and measures to be included in the evaluation plan.
Additional links: Flex Program Glossary of Evaluation Terms, Quick List: Flex Program Evaluation Resources
Date: 10/2023
Sponsoring organization: National Rural Health Resource Center
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Offers guidance to state Flex program coordinators to incorporate performance management and evaluation into Flex program operations as required by the Flex Program Cooperative Agreement. Supports the state's capacity for assessing program activities, making improvements, and establishing if activities are effective. Defines key terms and concepts, discusses reporting requirements, demonstrates a performance year work plan, covers data collection, and provides examples of goals and measures to be included in the evaluation plan.
Additional links: Flex Program Glossary of Evaluation Terms, Quick List: Flex Program Evaluation Resources
Date: 10/2023
Sponsoring organization: National Rural Health Resource Center
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Early Learnings From the Rural Health Redesign Center and its Rural Emergency Hospital Technical Assistance Center
Provides a brief overview of the Rural Emergency Hospital (REH) designation and the Rural Health Redesign Center's Rural Emergency Hospital Technical Assistance Center (REH-TAC). Describes the characteristics of Critical Access Hospitals (CAHs) and rural prospective payment system (PPS) hospitals that have explored REH conversion and have sought technical assistance from REH-TAC. Includes data on net patient revenue, operating income, margins, annualized 340B revenue, and more, by hospital type. Highlights common concerns raised by hospitals exploring REH conversion.
Date: 10/2023
Sponsoring organization: Rural Health Redesign Center
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Provides a brief overview of the Rural Emergency Hospital (REH) designation and the Rural Health Redesign Center's Rural Emergency Hospital Technical Assistance Center (REH-TAC). Describes the characteristics of Critical Access Hospitals (CAHs) and rural prospective payment system (PPS) hospitals that have explored REH conversion and have sought technical assistance from REH-TAC. Includes data on net patient revenue, operating income, margins, annualized 340B revenue, and more, by hospital type. Highlights common concerns raised by hospitals exploring REH conversion.
Date: 10/2023
Sponsoring organization: Rural Health Redesign Center
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MBQIP Quality Measures National Annual Report - 2022
Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2022. 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: 10/2023
Sponsoring organization: Flex Monitoring Team
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Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2022. 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: 10/2023
Sponsoring organization: Flex Monitoring Team
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Provision of Hospice Services by Critical Access Hospitals: Strengths and Challenges
Describes the characteristics of Critical Access Hospitals (CAHs) that report providing hospice services by analyzing data from the 2021 American Hospital Association (AHA) annual survey. Presents findings from qualitative interviews with seven CAHs who report providing hospice care, including how CAHs provide hospice services, the advantages CAHs may have when providing end-of-life care, and what CAH-specific barriers exist in providing such care.
Author(s): Robert Barclay, Megan Lahr, Hannah MacDougall, Abigail Wenninger
Date: 10/2023
Sponsoring organization: Flex Monitoring Team
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Describes the characteristics of Critical Access Hospitals (CAHs) that report providing hospice services by analyzing data from the 2021 American Hospital Association (AHA) annual survey. Presents findings from qualitative interviews with seven CAHs who report providing hospice care, including how CAHs provide hospice services, the advantages CAHs may have when providing end-of-life care, and what CAH-specific barriers exist in providing such care.
Author(s): Robert Barclay, Megan Lahr, Hannah MacDougall, Abigail Wenninger
Date: 10/2023
Sponsoring organization: Flex Monitoring Team
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Recovering from a Cybersecurity Attack and Protecting the Future in Small, Rural Health Organizations
Discusses the impact cyber-attacks can have on rural healthcare facilities. Features two Critical Access Hospital leaders describing attacks at their organizations. Shares insights from an information technology compliance expert, including actions organizations can take to protect themselves.
Author(s): Tami Lichtenberg
Citation: Rural Monitor
Date: 10/2023
Sponsoring organization: Rural Health Information Hub
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Discusses the impact cyber-attacks can have on rural healthcare facilities. Features two Critical Access Hospital leaders describing attacks at their organizations. Shares insights from an information technology compliance expert, including actions organizations can take to protect themselves.
Author(s): Tami Lichtenberg
Citation: Rural Monitor
Date: 10/2023
Sponsoring organization: Rural Health Information Hub
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The Pennsylvania Rural Health Model (PARHM): Third Annual Evaluation Report
Evaluates the third 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 2021. Includes three case studies discussing three themes: the recruitment and retention of system-affiliated hospitals, engagement and coordination with community organizations and providers, and exploring service line changes.
Additional links: Appendix, Findings at a Glance
Date: 09/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluates the third 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 2021. Includes three case studies discussing three themes: the recruitment and retention of system-affiliated hospitals, engagement and coordination with community organizations and providers, and exploring service line changes.
Additional links: Appendix, Findings at a Glance
Date: 09/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Characteristics of Short-Term Acute Care Hospitals That Experienced a Ransomware Attack from 2016 to 2021
Analyzed short-term acute care hospitals experiencing a ransomware attack between 2016 and 2019 to identify characteristics associated with an attack. Considered variables such as rurality, various financial characteristics, information technology infrastructure, and more. Includes recommendation for future research regarding rural impacts.
Author(s): Claire C. McGlave, Sayeh S. Nikpay, Carrie Henning-Smith, Katie Rydberg, Hannah T. Neprash
Citation: Health Affairs Scholar, 1(3)
Date: 09/2023
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Analyzed short-term acute care hospitals experiencing a ransomware attack between 2016 and 2019 to identify characteristics associated with an attack. Considered variables such as rurality, various financial characteristics, information technology infrastructure, and more. Includes recommendation for future research regarding rural impacts.
Author(s): Claire C. McGlave, Sayeh S. Nikpay, Carrie Henning-Smith, Katie Rydberg, Hannah T. Neprash
Citation: Health Affairs Scholar, 1(3)
Date: 09/2023
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