Rural Health
Resources by Topic: Critical Access Hospitals
Factors Associated with Lengths-of-Stay for Inpatients with Substance Use Disorders
Policy brief identifying factors associated with inpatient length-of-stay (LOS) for the treatment of substance use disorders (SUDs) and exploring whether there are systematic differences in LOS for rural and urban residents. Includes statistics on characteristics of stays for a primary SUD diagnosis in Kentucky, North Carolina, Vermont, and Washington in 2018, with breakdowns by Mental Health Professional Shortage Area and rural or urban location, and selected factors on LOS for an SUD diagnosis, with breakdowns by mental diagnoses, chronic conditions, and sociodemographic measures.
Author(s): Curt Mueller, Craig Holden, Shena Popat, Alana Knudson
Date: 04/2023
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Policy brief identifying factors associated with inpatient length-of-stay (LOS) for the treatment of substance use disorders (SUDs) and exploring whether there are systematic differences in LOS for rural and urban residents. Includes statistics on characteristics of stays for a primary SUD diagnosis in Kentucky, North Carolina, Vermont, and Washington in 2018, with breakdowns by Mental Health Professional Shortage Area and rural or urban location, and selected factors on LOS for an SUD diagnosis, with breakdowns by mental diagnoses, chronic conditions, and sociodemographic measures.
Author(s): Curt Mueller, Craig Holden, Shena Popat, Alana Knudson
Date: 04/2023
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Closed, Converted, Merged, and New Hospitals with Medicare Rural Designations: January 2018-November 2022
Provides an overview of four Medicare rural hospital designations - Critical Access Hospital, Low-Volume Hospital, Medicare Dependent Hospital, and Sole Community Hospital - and factors related to financial distress that these designations are intended to address. Explores the number of rural-designated hospitals that have closed, merged, converted, or opened between January 2018-November 2022 and compares the number of rural-designated hospitals with the number of non-designated hospitals. Outlines considerations for Congress regarding policy options for rural hospitals and access to healthcare services in rural areas.
Date: 04/2023
Sponsoring organization: Congressional Research Service
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Provides an overview of four Medicare rural hospital designations - Critical Access Hospital, Low-Volume Hospital, Medicare Dependent Hospital, and Sole Community Hospital - and factors related to financial distress that these designations are intended to address. Explores the number of rural-designated hospitals that have closed, merged, converted, or opened between January 2018-November 2022 and compares the number of rural-designated hospitals with the number of non-designated hospitals. Outlines considerations for Congress regarding policy options for rural hospitals and access to healthcare services in rural areas.
Date: 04/2023
Sponsoring organization: Congressional Research Service
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Analysis of Hospital Operating Margins and Provision of Safety Net Services
Explores the association between five hospital safety net services - undercompensated care measured using the Disproportionate Share Hospital index, uncompensated care, essential community services, and Sole Community Hospital and Critical Access Hospital status - and hospital operating margins. Includes information on the relationship between bed count, Census region, urban/rural location, ownership status, and having a Graduate Medical Education residency program with operating margins.
Author(s): Lukas K. Gaffney, Kenneth A. Michelson
Citation: JAMA Network Open, 6(4), e238785
Date: 04/2023
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Explores the association between five hospital safety net services - undercompensated care measured using the Disproportionate Share Hospital index, uncompensated care, essential community services, and Sole Community Hospital and Critical Access Hospital status - and hospital operating margins. Includes information on the relationship between bed count, Census region, urban/rural location, ownership status, and having a Graduate Medical Education residency program with operating margins.
Author(s): Lukas K. Gaffney, Kenneth A. Michelson
Citation: JAMA Network Open, 6(4), e238785
Date: 04/2023
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Better Together: Rural Hospital High-Value Networks
Examines how rural hospital high-value networks can create economies of scale and value-based care capacity in order to enter into value-based payment contracts.
Author(s): Clint MacKinney, Nate White, Brett Norell
Citation: Rural Monitor
Date: 04/2023
Sponsoring organization: Rural Health Information Hub
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Examines how rural hospital high-value networks can create economies of scale and value-based care capacity in order to enter into value-based payment contracts.
Author(s): Clint MacKinney, Nate White, Brett Norell
Citation: Rural Monitor
Date: 04/2023
Sponsoring organization: Rural Health Information Hub
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Report to Congress on Medicaid and CHIP, March 2023
Reports on four aspects of Medicaid: 1) collecting and reporting Medicaid race and ethnicity data, 2) increasing the transparency and improving the collection of nursing facility payment data, 3) strengthening evidence under Medicaid drug coverage, and 4) reviewing hospital payment policy for the nation's safety-net hospitals. Chapter 4 examines the relationship between disproportionate share hospital (DSH) allotments to states and the number of uninsured individuals, the amounts and sources of hospitals' uncompensated care costs, and the number of hospitals with high levels of uncompensated care that also provide essential community services. Table 4-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2023
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Reports on four aspects of Medicaid: 1) collecting and reporting Medicaid race and ethnicity data, 2) increasing the transparency and improving the collection of nursing facility payment data, 3) strengthening evidence under Medicaid drug coverage, and 4) reviewing hospital payment policy for the nation's safety-net hospitals. Chapter 4 examines the relationship between disproportionate share hospital (DSH) allotments to states and the number of uninsured individuals, the amounts and sources of hospitals' uncompensated care costs, and the number of hospitals with high levels of uncompensated care that also provide essential community services. Table 4-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2023
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Perspectives on the Long of COVID: From Doomscrolling to Rural Management Strategies
An overview of how Long COVID is impacting rural areas. Features a Tennessee rural health researcher sharing his Long COVID experience and a rural New York healthcare system discussing the condition's management options.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 03/2023
Sponsoring organization: Rural Health Information Hub
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An overview of how Long COVID is impacting rural areas. Features a Tennessee rural health researcher sharing his Long COVID experience and a rural New York healthcare system discussing the condition's management options.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 03/2023
Sponsoring organization: Rural Health Information Hub
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State Flex Program Staff Sustainability Guide and Toolkit
A guide for state Flex Programs to help recruit good Flex Program staff, train them successfully, retain staff longer, and plan an orderly process of finding and training new staff before the outgoing staff leave. Presents a Staff Sustainability Cycle, a process for improving the retention of high-performing Flex Program staff, and outlines specific strategies and practical tools for addressing each component of the cycle.
Date: 03/2023
Sponsoring organization: National Rural Health Resource Center
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A guide for state Flex Programs to help recruit good Flex Program staff, train them successfully, retain staff longer, and plan an orderly process of finding and training new staff before the outgoing staff leave. Presents a Staff Sustainability Cycle, a process for improving the retention of high-performing Flex Program staff, and outlines specific strategies and practical tools for addressing each component of the cycle.
Date: 03/2023
Sponsoring organization: National Rural Health Resource Center
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Modernizing Payment to Critical Access Hospitals: A Proposal for the Next Iteration of the Flex Program
Commentary briefly describing the history the Medicare Rural Hospital Flexibility Program (Flex) and Cost-Based Reimbursement (CBR) for Medicare. Outlines the challenges of CBR for Critical Access Hospitals (CAH) and proposes a new payment system.
Author(s): Clint MacKinney, Keith Mueller, Alva Ferdinand, et al.
Citation: Journal of Rural Health, 39(4), 716-718
Date: 02/2023
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Commentary briefly describing the history the Medicare Rural Hospital Flexibility Program (Flex) and Cost-Based Reimbursement (CBR) for Medicare. Outlines the challenges of CBR for Critical Access Hospitals (CAH) and proposes a new payment system.
Author(s): Clint MacKinney, Keith Mueller, Alva Ferdinand, et al.
Citation: Journal of Rural Health, 39(4), 716-718
Date: 02/2023
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Patient Transfers to and from Critical Access Hospitals During the COVID-19 Pandemic
Examines inbound and outbound transfer patient volumes among Critical Access Hospitals (CAHs) during the COVID-19 pandemic. Discusses the barriers and facilitators to transferring patients that CAHs experienced. Compares transfer volume and facilitators for outbound transfers by CAH system ownership status.
Author(s): Abigail Wenninger, Madeleine Pick, Megan Lahr
Date: 02/2023
Sponsoring organization: Flex Monitoring Team
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Examines inbound and outbound transfer patient volumes among Critical Access Hospitals (CAHs) during the COVID-19 pandemic. Discusses the barriers and facilitators to transferring patients that CAHs experienced. Compares transfer volume and facilitators for outbound transfers by CAH system ownership status.
Author(s): Abigail Wenninger, Madeleine Pick, Megan Lahr
Date: 02/2023
Sponsoring organization: Flex Monitoring Team
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Evaluation of Post-Discharge Engagement for Emergency Department Patients with Opioid Use History Who Received Telehealth Recovery Coaching Services
Examines successful interventions for patients in emergency departments (EDs) who receive peer recovery coach (PRC) services via telehealth that support patients with opioid use disorder (OUD). Analyzes 13 EDs in Indiana who implemented telehealth PRC services starting in 2018, including 7 rural Critical Access Hospitals (CAHs). Includes rate of successful follow-ups proceeding PRC services broken down by patient age, sex, race, drug use method, referral types, and metro, small, or rural living location.
Author(s): Dennis P. Watson, Peter Phalen, Spencer Medcalf, Sarah Messmer, Alan McGuire
Citation: Substance Abuse Treatment, Prevention, and Policy, 18(9)
Date: 02/2023
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Examines successful interventions for patients in emergency departments (EDs) who receive peer recovery coach (PRC) services via telehealth that support patients with opioid use disorder (OUD). Analyzes 13 EDs in Indiana who implemented telehealth PRC services starting in 2018, including 7 rural Critical Access Hospitals (CAHs). Includes rate of successful follow-ups proceeding PRC services broken down by patient age, sex, race, drug use method, referral types, and metro, small, or rural living location.
Author(s): Dennis P. Watson, Peter Phalen, Spencer Medcalf, Sarah Messmer, Alan McGuire
Citation: Substance Abuse Treatment, Prevention, and Policy, 18(9)
Date: 02/2023
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