Rural Health
Resources by Topic: Critical Access Hospitals
Rural Hospital Experiences in the Colorado Hospital Transformation Program
Provides an overview of the Colorado Hospital Transformation Program (CO HTP), a 5-year program that ties Medicaid supplemental payments to hospitals' ability to meet performance targets through September 2026. Describes the experiences of three Critical Access Hospitals (CAHs) and explores how CO HTP impacts rural hospitals. Covers planning and community engagement, quality of care, and healthcare costs.
Date: 03/2025
Sponsoring organization: Rural Health Value
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Provides an overview of the Colorado Hospital Transformation Program (CO HTP), a 5-year program that ties Medicaid supplemental payments to hospitals' ability to meet performance targets through September 2026. Describes the experiences of three Critical Access Hospitals (CAHs) and explores how CO HTP impacts rural hospitals. Covers planning and community engagement, quality of care, and healthcare costs.
Date: 03/2025
Sponsoring organization: Rural Health Value
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February 2025 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) February 2025 meeting. Covers transitions of care for children and youth with special healthcare needs (CYSHCN), hospital non-disproportionate share hospital supplemental payments and directed payment targeting, improving access to medications for opioid use disorder, healthcare access for children in foster care, and more. Includes rural references throughout.
Additional links: Hospital Non-DSH Supplemental Payment and Directed Payment Targeting Analyses
Date: 02/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) February 2025 meeting. Covers transitions of care for children and youth with special healthcare needs (CYSHCN), hospital non-disproportionate share hospital supplemental payments and directed payment targeting, improving access to medications for opioid use disorder, healthcare access for children in foster care, and more. Includes rural references throughout.
Additional links: Hospital Non-DSH Supplemental Payment and Directed Payment Targeting Analyses
Date: 02/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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North Carolina Rural Hospital Program: 2024 Profile
Fact sheet with North Carolina rural hospital-related statistics on grants, return on investment and economic impact, technical assistance, and total program funding. Includes a county-level map showing locations of Critical Access Hospitals and small rural hospitals.
Date: 02/2025
Sponsoring organization: North Carolina Department of Health and Human Services
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Fact sheet with North Carolina rural hospital-related statistics on grants, return on investment and economic impact, technical assistance, and total program funding. Includes a county-level map showing locations of Critical Access Hospitals and small rural hospitals.
Date: 02/2025
Sponsoring organization: North Carolina Department of Health and Human Services
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Current Medicare Beneficiary Quality Improvement Project (MBQIP) Measures
Chart outlining the required and optional MBQIP measures. Measures are broken down into two categories, core and additional, and then into five domains: global measures, patient safety, patient engagement, care coordination, and emergency department. MBQIP is a Medicare Rural Hospital Flexibility (Flex) quality improvement grant program for Critical Access Hospitals.
Date: 02/2025
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
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Chart outlining the required and optional MBQIP measures. Measures are broken down into two categories, core and additional, and then into five domains: global measures, patient safety, patient engagement, care coordination, and emergency department. MBQIP is a Medicare Rural Hospital Flexibility (Flex) quality improvement grant program for Critical Access Hospitals.
Date: 02/2025
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
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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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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 and 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 and 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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