Rural Health
Resources by Topic: Critical Access Hospitals
Clarity for Rural Emergency Hospitals and Changes for Critical Access Hospitals: CMS Finalizes Conditions of Participation and Payment and Enrollment Policies But Pauses Stark Law Flexibilities
Provides an overview of the Rural Emergency Hospitals (REHs) provisions of the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule. Discusses REH reimbursement, Conditions of Participation (CoPs), enrollment provisions, and Stark Law regulatory modifications to accommodate REHs. Highlights changes to the definition of "primary roads" related to Critical Access Hospital (CAH) CoPs.
Author(s): Emily Jane Cook, Caroline Reignley, Amber Arnold, Sandra M. DiVarco
Date: 11/2022
Sponsoring organization: McDermott Will & Emery
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Provides an overview of the Rural Emergency Hospitals (REHs) provisions of the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule. Discusses REH reimbursement, Conditions of Participation (CoPs), enrollment provisions, and Stark Law regulatory modifications to accommodate REHs. Highlights changes to the definition of "primary roads" related to Critical Access Hospital (CAH) CoPs.
Author(s): Emily Jane Cook, Caroline Reignley, Amber Arnold, Sandra M. DiVarco
Date: 11/2022
Sponsoring organization: McDermott Will & Emery
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2022 National Healthcare Quality and Disparities Report
Provides a comprehensive summary and data analysis of healthcare quality and access in the U.S. Addresses access to healthcare, patient safety, person-centered care, care coordination, effective treatment, healthy living, and care affordability. Includes a discussion of rural hospital closures and the impact on the distance required to access selected healthcare services.
Date: 11/2022
Sponsoring organization: Agency for Healthcare Research and Quality
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Provides a comprehensive summary and data analysis of healthcare quality and access in the U.S. Addresses access to healthcare, patient safety, person-centered care, care coordination, effective treatment, healthy living, and care affordability. Includes a discussion of rural hospital closures and the impact on the distance required to access selected healthcare services.
Date: 11/2022
Sponsoring organization: Agency for Healthcare Research and Quality
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Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Acquisition; Rural Emergency Hospitals: Payment Policies, Conditions of Participation, Provider Enrollment, Physician Self-Referral; New Service Category for Hospital Outpatient Department Prior Authorization Process; Overall Hospital Quality Star Rating; COVID-19
Establishes the Rural Emergency Hospital (REH) provider type. Outlines REH payment policy, Conditions of Participation (CoPs), quality measures, and enrollment policy. Outlines changes to the Critical Access Hospitals (CAH) CoPs regarding location and distance requirements, patient's rights requirements, and flexibilities for CAHs that are part of a larger health system. Among other things, this rule also revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and finalizes provisions included in the COVID-19 interim final rules.
Additional links: Fact Sheet
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Establishes the Rural Emergency Hospital (REH) provider type. Outlines REH payment policy, Conditions of Participation (CoPs), quality measures, and enrollment policy. Outlines changes to the Critical Access Hospitals (CAH) CoPs regarding location and distance requirements, patient's rights requirements, and flexibilities for CAHs that are part of a larger health system. Among other things, this rule also revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and finalizes provisions included in the COVID-19 interim final rules.
Additional links: Fact Sheet
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Financial Characteristics of Critical Access Hospitals (CAHs) Participating in Accountable Care Organizations (ACO)
Examines Critical Access Hospital (CAH) participation in Medicare and non-Medicare Accountable Care Organizations (ACOs) in 2019. Compares the organizational and financial characteristics of CAHs across facilities that participate in ACOs and those that do not participate in an ACO. Includes data on profitability, liquidity, outpatient revenue, and Medicare payer mix.
Author(s): Angelina Budko, George Pink, Susie Gurzenda, Ann Howard, Kristin L. Reiter
Date: 11/2022
Sponsoring organization: Flex Monitoring Team
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Examines Critical Access Hospital (CAH) participation in Medicare and non-Medicare Accountable Care Organizations (ACOs) in 2019. Compares the organizational and financial characteristics of CAHs across facilities that participate in ACOs and those that do not participate in an ACO. Includes data on profitability, liquidity, outpatient revenue, and Medicare payer mix.
Author(s): Angelina Budko, George Pink, Susie Gurzenda, Ann Howard, Kristin L. Reiter
Date: 11/2022
Sponsoring organization: Flex Monitoring Team
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The Impact of Medicare Shared Savings Program Participation on Hospital Financial Performance: An Event-Study Analysis
Examines the effects of hospitals' participation in the Medicare Shared Savings Program (MSSP) on their financial performance. Compares within-hospital changes over time between MSSP and non-MSSP hospitals. Includes a comparison of the effects of MSSP participation between Critical Access Hospitals (CAHs) and non-CAHs.
Author(s): Huang Huang, Fred Ullrich, A. Clinton MacKinney, Keith Mueller
Citation: Health Services Research, 2022
Date: 10/2022
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Examines the effects of hospitals' participation in the Medicare Shared Savings Program (MSSP) on their financial performance. Compares within-hospital changes over time between MSSP and non-MSSP hospitals. Includes a comparison of the effects of MSSP participation between Critical Access Hospitals (CAHs) and non-CAHs.
Author(s): Huang Huang, Fred Ullrich, A. Clinton MacKinney, Keith Mueller
Citation: Health Services Research, 2022
Date: 10/2022
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Delivery of Cancer Screening and Treatment in Critical Access Hospitals
Summarizes results of a survey of 135 Critical Access Hospitals (CAHs) regarding cancer screening and treatment provided by CAHs. Describes the role of visiting providers and the use of telemedicine in cancer screening and treatment.
Author(s): Megan Lahr, Xiomara Santana, Helen Parsons, Nathan Bean, Ira Moscovice
Date: 10/2022
Sponsoring organization: Flex Monitoring Team
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Summarizes results of a survey of 135 Critical Access Hospitals (CAHs) regarding cancer screening and treatment provided by CAHs. Describes the role of visiting providers and the use of telemedicine in cancer screening and treatment.
Author(s): Megan Lahr, Xiomara Santana, Helen Parsons, Nathan Bean, Ira Moscovice
Date: 10/2022
Sponsoring organization: Flex Monitoring Team
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Assessment of Strategies Used in US Hospitals to Address Social Needs During the COVID-19 Pandemic
Presents findings on efforts to address social determinants of health (SDOH) by rural hospitals, Critical Access Hospitals (CAHs), and safety-net hospitals according to 2020 American Hospital Association survey data. Discusses rates of social needs among patient populations served by rural and urban hospitals and rates of SDOH screening and community partnerships.
Author(s): Jose F. Figueroa, Ciara Duggan, Cristina Toledo-Cornell, et al.
Citation: JAMA Health Forum, 3(10), e223764
Date: 10/2022
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Presents findings on efforts to address social determinants of health (SDOH) by rural hospitals, Critical Access Hospitals (CAHs), and safety-net hospitals according to 2020 American Hospital Association survey data. Discusses rates of social needs among patient populations served by rural and urban hospitals and rates of SDOH screening and community partnerships.
Author(s): Jose F. Figueroa, Ciara Duggan, Cristina Toledo-Cornell, et al.
Citation: JAMA Health Forum, 3(10), e223764
Date: 10/2022
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Small Rural Hospitals with Low-Volume Emergency Departments that May Convert to a Rural Emergency Hospital (REH)
Explores a variety of characteristics of Critical Access Hospitals (CAHs) and rural hospitals eligible to convert to the Rural Emergency Hospital (REH) designation, including patient volume, services and technology, EMS, and clinical staffing characteristics. Compares eligible hospitals by emergency department volume in 2019. Summarizes observations made by emergency department physician advisers regarding this data and REH implementation concerns.
Author(s): Margaret Greenwood-Ericksen, TJ Grant, Susie Gurzenda, et al.
Date: 10/2022
Sponsoring organization: North Carolina Rural Health Research Program
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Explores a variety of characteristics of Critical Access Hospitals (CAHs) and rural hospitals eligible to convert to the Rural Emergency Hospital (REH) designation, including patient volume, services and technology, EMS, and clinical staffing characteristics. Compares eligible hospitals by emergency department volume in 2019. Summarizes observations made by emergency department physician advisers regarding this data and REH implementation concerns.
Author(s): Margaret Greenwood-Ericksen, TJ Grant, Susie Gurzenda, et al.
Date: 10/2022
Sponsoring organization: North Carolina Rural Health Research Program
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Safety Assurance Factors for EHR Resilience (SAFER) Guides Requirements
Infographic displaying the differences in the Safety Assurance Factors for EHR Resilience (SAFER) Guide requirements for hospitals and Critical Access Hospitals (CAHs) participating in the Medicare Promoting Interoperability Program and eligible clinicians participating in the Merit-based Incentive Payment System (MIPS) Promoting Interoperability performance category for eligible clinicians.
Date: 10/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Infographic displaying the differences in the Safety Assurance Factors for EHR Resilience (SAFER) Guide requirements for hospitals and Critical Access Hospitals (CAHs) participating in the Medicare Promoting Interoperability Program and eligible clinicians participating in the Merit-based Incentive Payment System (MIPS) Promoting Interoperability performance category for eligible clinicians.
Date: 10/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Using Z Codes to Improve Health Equity in Rural Indiana
Describes how Cameron Memorial Community Hospital, a Critical Access Hospital in Indiana, used ICD-10-CM Z codes to detect and address patients' social needs as part of its health equity strategy.
Date: 10/2022
Sponsoring organization: American Hospital Association
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Describes how Cameron Memorial Community Hospital, a Critical Access Hospital in Indiana, used ICD-10-CM Z codes to detect and address patients' social needs as part of its health equity strategy.
Date: 10/2022
Sponsoring organization: American Hospital Association
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